By Sam Whitehead, Phil Galewitz and Katheryn Houghton, Kff Health News
For many years, Eric Wunderlin’s health problems have made it difficult to find a stable job.
Folling to manage depression and diabetes, Wunderlin worked part -time and a minimum wage in Dayton, Ohio, doing so little that he said that he had sometimes to choose between paying the rent and buying food.
But in 2018, his Caresource Medicaid health plan offered him help to find a job. He linked it to a life coach, who helped him find full -time work with health benefits. Now, he works for a non -profit social service agency, a job that, according to him, has given him enough financial stability to plan for European holidays next year.
“I feel like a real person and I can go doing things,” said Wunderlin, 42. “I feel like I am getting out of this crisis.”
The Republicans of Congress and several States, including Ohio, Iowa and Montana, are pushing to implement work requirements for unabled adults, arguing that a mandate encouraged the registrants to find a job. And for the Republicans to push to demand that the registrants of Medicaid work, the history of Wunderlin could be considered as proof that the government’s health coverage can help people find a job and, in the end, to reduce their need for public assistance.
However, his experience is rare. Medicaid generally does not offer such aid, and when states try to help, such efforts are limited.
And the opponents point out that most of the beneficiaries of Medicaid already have jobs and say that such a mandate would only kick the eligible people from Medicaid, rather than improving their economic prospects. Almost two -thirds of Medicadid registrants work, most of the others acting as caregivers, going to school or unable to employ a job due to disability or illness, according to KFF, a non -profit organization of health information that includes Kff Health News.
The existing efforts to help the beneficiaries of Medicaid to obtain a job have had a limited success because there is not a lot of “place to move the needle,” said Ben Sommers, professor of health economics at the Harvard Th Chan School of Public Health. Most MEDICAID registrations are already working-but not in jobs with health benefits, he said.
“The current argument that some people make, is that there are many people who Free in Medicaid,” he said. “It is simply not supported by the evidence.”
Use health programs to encourage work
The Congress controlled by the GOP could authorize or oblige states to implement a MEDICAIDE work requirement in the context of renovation and reduction of Medicaid workforce. The first Trump administration encouraged these working mandates, but many were canceled by federal judges who said they were illegal under federal law.
Policy experts and state officials claim that more attention should be given to investments that have helped people find better jobs – personalized life coaching to, in some cases, hiring registrants directly.
They argue that the work requirements are not sufficient alone. “The transition to economic mobility requires a scale, not a stick,” said Farah Khan, a Brookings Institution scholarship holder, a non -partisan reflection group.
While Medicaid’s work requirements have been debated for decades, the question has become more stormy at 40 states and Washington, DC, has widened the eligibility for Medicaid under the Act respecting affordable care for the vast majority of adults with low income. Consequently, more than 20 million adults have acquired coverage – but the Republicans now plan to eliminate the billions of additional federal funds that have helped states to extend eligibility beyond groups, including many children, pregnant women and disabled people.
Only Georgia and Arkansas have implemented mandates that certain registered medicaids work, volunteer, go to school or register for vocational training. But a study that the Sommers co-authors have shown no evidence, the work requirements in the Arkansas program led more people to work, in part because most of those who could work were already.
In Arkansas, more than 18,000 people lost coverage under the state requirement before the policy was suspended by a federal judge in 2019 after less than a year. Those who have lost their Medicaid health care declared unconscious or confused on how to report working hours. Since 2023, the Arkansas has given Medicaid health plans to help registrants train jobs, but so far, few have benefited.
Certain plans, including Arkansas Blue Cross and Blue Shield’s, offer members $ 25 at $ 65 to finish a certificate of “career preparation”. In 2024, some Arkansas health plans offered educational videos registered on subjects such as taxes and cryptocurrency.
Health plans are not encouraged to help someone find a better paid job, as it could mean losing a customer if he is doing too much to qualify for Medicaid, said Karin Vanzant, vice-president of Clearlink Partners, a health care consulting company.
Rather than offering incentives to provide professional training, some states, such as California and Ohio, need insurance companies that direct Medicaid to help registrants find work.
In Montana, where some legislators push to implement work requirements, a promising optional program has almost collapsed after state legislators demanded that it be outsourced to private entrepreneurs.
During the first three years of the program, the State paired 32,000 registered Medicaid with vocational training programs funded by the federal government. Most had higher wages a year after the training start, noted the state.
But registration fell to only 11 people, according to the latest data provided by the State Labor Department.
Sarah Swanson, who heads the department, said that many of the non -profit entrepreneurs who directed the program were closed. “There was no real share for that to provide direct services to people who crossed our door,” she said. The State hopes to revive vocational training by allowing the ministry to work alongside entrepreneurs to reach more people.
Hunting for results
State officials say that they do not have much data to follow the effectiveness of existing employment programs offered by Medicaid plans.
Stephanie O’grady, spokesperson for the Ohio de Medicaid department, said the state did not follow the results because “health plans are not employment agencies”.
Caresource officials, who operates Medicaid plans in several states, claim that he has around 2,300 registered Medicaid and Aca Marketplace in his JobConnect – approximately 1,400 in Ohio, 500 in Georgia and 400 in Indiana.
The program connects job seekers to a life coach who advises them on skills such as “presenting themselves in time, dressing the role of interviews and selling during the interview,” said Jesse Reed, director of life services at Caresource in Ohio.
Since 2023, around 800 people have found jobs as part of the program, according to Josh Boynton, vice-president of Caresource. The health plan itself hired 29 registered Medicaid in customer service, pharmacy and other positions-almost all full time with benefits, he said.
In 2022, California began to offer non -traditional health services through Medicaid – including helping jobs – for homeless registrants or serious mental illness, or that risk avoidable emergencies. In September, it had served nearly 280,000 registered, but the state has no data on the number of employees.
The Pittsburgh University Medical Center, which is among the largest private employers in Pennsylvania, managing both a sprawling hospital system and a Medicaid plan, has hired more than 10,000 of its registered Medicaid since 2021 through its training and support services. Among other jobs, they have taken positions from warehouse workers, customer service representatives and medical assistants.
The vast majority left little paid jobs for full -time positions with health benefits, said Dan Lavallee, principal director of the Center for Social Impact of the UPMC Health Plan. “Our Pathways to Work program is a model for the nation,” he said.
Josh Archambault, principal member of the Cicero Institute, said Medicaid should focus on improving the financial health of registered persons.
While the first Trump administration approved Medicaid’s work requirements in 13 states, the Biden administration or federal judges have blocked all georgia.
“I do not think that the States were likely to experiment and try to understand what works,” said Archambault.
Kff Health News’ main correspondent Angela Hart has contributed to this report.
© 2025 Kff Health News. Distributed by Tribune Content Agency, LLC.
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