Able-bodied participants in North Carolina’s Medicaid program would be required to fulfill a work and community engagement requirement under a bill filed earlier today by Senators Ralph Hise (R- Mitchell), Joyce Krawiec (R-Forsyth), and Dan Bishop (R-Mecklenburg). 

 

Senate Bill 387 would require non-elderly, non-pregnant adult Medicaid beneficiaries who are not disabled to work or participate in community engagement activities. The specific requirements would be developed by the Department of Health and Human Services (DHHS) and would be based on the work requirements for Able-Bodied Adults without Dependents (ABAWDs) policy under the Supplemental Nutrition Assistance Program (SNAP). 

 

The work requirements for ABAWD policy under SNAP require program beneficiaries to participate in 20 hours of community engagement per week, which may include working or looking for a job, volunteering, and pursuing educational opportunities. 

 

“Despite the hundreds of billions of dollars that have been pumped into the Medicaid system at both the state and federal level, there are still numerous studies that show Medicaid does not guarantee improved health outcomes,” Hise, Krawiec and Bishop said in a joint statement. “Conversely, there is strong evidence suggesting that productive work and community engagement may improve health outcomes. By encouraging these folks already on Medicaid to work and engage with their community, not only are we increasing their chances of improved health outcomes, we are also increasing their chances of someday moving off government assistance programs altogether. ” 

 

In addition to exempting elderly, disabled and pregnant Medicaid enrollees from this work and community engagement requirement, the bill also includes a list of 21 other exemptions. These include Individuals under 19 and over 64, Individuals who have been certified as unfit for employment for physical or mental health reasons, and Individuals with chronic illnesses as well as many others.

 

According to the federal Center for Medicaid (CMS), a number of existing studies provide strong evidence that unemployment is generally harmful to health, including higher mortality; poorer general health; poorer mental health; and higher medical consultation and hospital admission rates. A 2013 Gallup poll found that unemployed Americans are more than twice as likely as those with full-time jobs to say they currently have or are being treated for depression.