Today, the U.S. Department of Health and Human Services (HHS) released new analysis showing that approximately 21 million Americans’ health coverage and access to care would be jeopardized if the draconian Medicaid work reporting requirements proposed by Congressional Republicans were implemented. The information, based on data from the Centers for Medicare & Medicaid Services (CMS), estimates the harmful effects on all states that have expanded Medicaid under the Affordable Care Act. New state-by-state fact sheets provide county-level analysis for the five most populous expansion states – California - PDF*, New York - PDF, Pennsylvania - PDF, Illinois - PDF, and Ohio - PDF. Overall, the results show that approximately 21 million people nationwide would be at risk of losing Medicaid coverage under the substantial bureaucratic red tape of the proposed new work reporting requirements if they were put in place.

Only one state has ever fully implemented work reporting requirements, and nearly 1 in 4 adults subject to the policy lost their health coverage—including working people and people with serious health conditions—with no evidence of increased employment. In fact, research shows that more than 95% of enrollees subject to the policy already met the requirements or should have qualified for an exemption – but many lost coverage because they couldn’t navigate the red tape. According to a recent HHS report, the vast majority of working-age Medicaid enrollees are already employed, have a disability, or are parents. However, loss of Medicaid coverage can force patients to change providers, skip medications, or face financial difficulties, and coverage loss has been tied to worse quality of care and worse health. In contrast, Medicaid coverage can support work by keeping people healthy while they are working or looking for work, studies have shown exit disclaimer icon.

The dramatic effect on coverage raises concerns that extreme proposals to add such requirements across the U.S. would undermine the progress made during the Biden-Harris Administration to expand coverage and access to high-quality affordable health care. The national uninsured rate reached an all-time low under President Biden and the Administration continues to work to expand coverage. HHS and the Biden-Harris Administration are committed to working with states to test new innovative ways to deliver health care, lower costs for Americans, and expand coverage; in contrast, efforts like Congressional Republicans’ budget proposal would make it harder for people to get health insurance and could take coverage away from millions of Americans.

For information on how many people in your state/county are at risk of losing coverage, visit: 20230425-data-by-state-and-county.pdf (hhs.gov) - PDF*

To see the number of Medicaid enrollees potentially subject to work reporting requirements, by state, (Medicaid expansion states only), please visit:

Link to national fact sheet here: national-work-requirements-fact-sheet.pdf (hhs.gov) - PDF*

County level data for all Medicaid expansion states can be found here: 20230425-data_by_state_and_county.pdf (hhs.gov) - PDF*

Fact sheets for the five most populous expansion states, including the county-by-county impact of work requirements, can be found below:

California - PDF*

New York - PDF*

Pennsylvania - PDF*

Illinois - PDF*

Ohio - PDF*

*This content is undergoing Section 508 remediation. For immediate assistance, please contact media@hhs.gov.