To date, Section 1115 waivers that condition Medicaid eligibility on beneficiaries’ meeting work and community engagement (CE) requirements have been approved by the Centers for Medicare & Medicaid Services (CMS) for eight states: Arizona, Arkansas, Indiana, Kentucky, Maine, Michigan, New Hampshire, and Wisconsin. Some of the waiver applications and approvals do not include projections of coverage impacts, an important consideration as these waivers move forward. Information that is now available on implementation experience in Arkansas offers key insights for other states.

In a new issue brief, supported by funding from the State Health and Value Strategies program, a grantee of the Robert Wood Johnson Foundation, Manatt Health provides estimates of potential impacts of Michigan’s work requirement based on the Arkansas experience and data available on the composition and demographics of the Michigan beneficiaries subject to the requirement, with adjustments that reflect the differences between the states.

Michigan’s waiver application seeking approval of work requirements did not include projected enrollment impacts, nor did a Senate Fiscal Agency analysis of the State’s legislation. A House Fiscal Agency analysis forecasted Medicaid expansion enrollment reductions of 4 to 8 percent. As this brief describes, information from Arkansas suggests that Michigan could see enrollment reductions that are more than three times the upper bound of the legislative estimate.

Click here to read the full report.

Support for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.