Medicaid work requirements and eligibility

Pennsylvania’s Medicaid program, also called Medical Assistance, provides insurance coverage for approximately 3 million people, including one in four adults and 39% of children, according to state data.

Work requirements proposed in the federal budget bill would apply to adults ages 19 to 64. They would have to work at least 80 hours a month and provide documented proof to state agencies in order to stay in the program.

States may have exemptions for people with children and those with disabilities, as well as adults who are sole caregivers, in school or pregnant.

Joanna Rosenhein, of the Pennsylvania Health Access Network, said that people will get cut from the program and lose coverage, even when they are meeting the work and income requirements, because of issues with missing or incomplete documentation and paperwork.

“Most people on Medicaid are already working,” Rosenheim said. “The rest are either caregivers, students, people with disabilities or severe health conditions, and those people will be at risk of losing their coverage because of paperwork requirements.”

Processing additional paperwork and carrying out more eligibility checks and renewals would fall to the states.

“The state is already overwhelmed,” she said, “and this will only add to their burden.”

Alisha Gillespie, of Chester, Pennsylvania, called the proposed cuts and requirements “inhumane” and said it would have been “impossible” to comply when she had Medicaid last year while battling breast cancer and raising three children.

“[There were] days that I couldn’t even get out of bed to make dinner, to even go to the bathroom,” she said. “So, I can’t imagine having even a part-time job to even try to make ends meet for surgeries or any type of treatment.”