Requiring people with mental health issues to work for Medicaid coverage can create barriers.
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At a time when Medicaid is increasingly under threat, people with mental health disabilities may find it not only harder to receive services, but also to stay in the federal program.
Medicaid is used by nearly 40% of adults under age 65 who have a mental health issues. Republican legislators have talked about slashing Medicaid for decades, and now they control both chambers of Congress, the White House and federal health agencies, drawing concerns about the future of the vital public safety net program.
Past efforts to undermine Medicaid have included work requirements for users, a policy that is being floated once again at the federal level. But studies have shown that Medicaid work requirements do not actually increase employment among program users, according to Jennifer Mathis, JD, deputy director of the Bazelon Center for Mental Health Law.
“In fact, in very large numbers, people are losing their Medicaid coverage, not because they weren’t looking for work, but because of confusion and barriers created by these requirements,” Mathis told The Nation’s Health.
The impact of losing Medicaid for people with mental health disabilities is particularly harmful, according to a Bazelon Center issue brief released in March.
Despite misbeliefs, most people who receive Medicaid coverage are employed, including people with mental health conditions. For those who do not work, it is often because of discrimination, stigma or the lack of accommodations offered by employers, the brief said.
Having access to health services through Medicaid is essential for people with mental health disabilities to land a job and stay employed, the brief said. And when they lose coverage, a downward spiral can result. People can become isolated, stop taking medications or for go counseling, which can lead to emergency visits, hospitalizations or other risks.
State Medicaid work requirements have typically mandated that users verify work hours or community engagement activities to retain coverage. Yet, as seen in states such as Arkansas, Michigan and New Hampshire, the policies have caused widespread confusion. Medicaid recipients are often kicked off rolls not from being unemployed, but from failing to report work hours correctly or from bureaucratic errors.
In Arkansas, over 18,000 people lost coverage within seven months, the brief said.
“In terms of human costs, you’re talking about the people remaining ill and not getting the care that they need, including basic medical services and mental health care,” Mathis said. “You’re talking about people losing jobs or not being able to get employed, because they are not getting the treatment that they need.”
For more on “Medicaid Work Requirements Harm People with Mental Health Disabilities,” visit www.bazelon.org.
- Copyright The Nation’s Health, American Public Health Association