Reporting Work Requirements: Bad at encouraging work, good at making people sick and hungry

Congress wants to make work reporting requirements in safety net programs harsher and more pervasive to remove supports from tens of thousands of Mainers and use that money to pay for tax cuts that overwhelmingly go to the wealthy. Maine has been down this road before and saw that work requirements take away help from people who need it and don’t support work.

The Congressional bill currently under consideration would make work requirements harsher in three ways. It would:

  • Expand the existing requirement in the Supplemental Nutrition Assistance Program (SNAP) for adults without dependents or a documented disability by increasing the age limit from 55 to 64, which will put 4,000 older adult Mainers newly at risk of losing food assistance.
  • Change the definition of “dependent” to only apply to children under the age of 7, which will put another 27,000 parents and caregivers of school-age kids at risk of losing food assistance. In total, 31,000 Mainers are likely to lose food assistance under these two changes.
  • Impose a similar work reporting requirement on the Medicaid (MaineCare) program for the first time in the program’s history. 34,000 Mainers are likely to lose health care under this change.

“Work requirements” are program cuts

While some Republicans have sought to portray work requirements as distinct from benefit cuts, the proven reality is these changes will remove millions of Americans from the affected programs, the majority of whom are working, caregiving, or suffering from a serious health condition that prevents them from working. Work requirements create a lot of new paperwork and administrative barriers. According to the Maine Department of Health and Human Services, these would cost $6 million a year in additional administrative costs alone. The extra bureaucratic hoops also lead to the disenrollment of many people who are meeting the requirements but just get caught up in red tape. By one estimate, 13% of people impacted by the Congressional proposal would not currently meet the work requirements for Medicaid and don’t qualify for an exemption, but the actual number who would lose care is three times higher (39%), meaning that the majority of people losing coverage already participate in the workforce or qualify for an exemption.

Approximately one third of Maine workers below traditional retirement age work less than full-time, year-round. In a seasonal economy like Maine’s, it can be particularly hard for people to meet a work reporting requirement on a consistent basis every month because the jobs simply aren’t available or the hours vary.

Many Mainers have health conditions that make it hard for them to work but are not always easy to prove to gain an exemption from a work requirement. As many as 110,000 Mainers aged 18 to 64 report having some kind of disability, but only 30,000 of them actually receive Social Security Disability benefits, leaving tens of thousands of Mainers with a harder time proving their disability to gain an exemption.

There are plenty of other obstacles to work that the bill doesn’t recognize. A 2021 survey of unemployed Mainers found that one in eight couldn’t work due to childcare problems, and 6% didn’t have reliable transportation.

Finally, it’s worth remembering that food and medical assistance are key to health and stability people need to engage in the labor force. Medicaid Expansion has increased employment among adults with disabilities and SNAP has also been shown to help people find and keep employment by freeing up money for expenses like childcare. Taking both away from folks who can’t find consistent work will only make their barriers to employment worse as well as make it harder for them to get by in general.

Work requirements in Maine and elsewhere caused hardship without boosting work

Maine has prior experience with expanding work requirements that proved unsuccessful. In late 2014, then-Governor Paul LePage expanded work requirements in the SNAP program for adults without a documented disability who did not have children at home. Nearly three quarters of the SNAP recipients who were subject to the new requirements lost their benefits, with tens of thousands losing assistance over the next few years. Many of those who lost benefits were still unable to find work in the year afterwards, and those who did had incomes well below the poverty line. A 2017 survey of Mainers who lost SNAP benefits due to the LePage policy changes found that almost 80% of them had to use food pantries more often after the change, and 86% said it led to them making difficult choices between paying for food and other necessities like rent or health care.

National research shows similar patterns in the SNAP program — the federal work reporting requirement makes it much more likely that people will lose food assistance but does nothing meaningful to help those folks find work.

Recently several states have experimented with work requirements in Medicaid, with similarly poor results:

  • Under Arkansas’ temporary Medicaid work requirement, one in four people subject to the new test lost their health care coverage, most of whom could not get alternative health insurance, and there was no evidence of increased employment as a result.
  • Georgia imposed the work requirement when they expanded Medicaid coverage under the Affordable Care Act. One year into the program, just 2% of people thought to be eligible for the program have enrolled, leaving hundreds of thousands of people unable to get health care. This is despite the state spending millions of dollars on consultants to conduct an outreach campaign.
  • New Hampshire suspended its Medicaid work requirement after it had trouble even notifying impacted enrollees about the change. Despite multiple outreach efforts, nearly half of the people potentially subject to the work requirement didn’t even receive notices from the state. Of those assessed for the work requirement, only one third were judged to be meeting it when the policy was suspended.

Congress must reject work requirements

Congress is at risk of repeating the mistakes made in Maine and other states and expanding them to the whole country in its reconciliation bill. Work requirements are efficient at taking food and health care away and creating more costly rules for states, but they don’t lead to more people working. Tens of thousands of Mainers will lose access to health care and food assistance and will suffer real hardships as a result. Congress should reject these harmful provisions to protect Maine people who are already working hard to make ends meet.