Congressional Republicans are considering legislation that would take Medicaid coverage away from people who can’t document that they meet work requirements. Low-paid workers are among the millions of people who would be at risk of losing coverage.[1]
Medicaid is a critical source of coverage for workers in low-paying jobs, which often don’t offer health benefits. Low-paid workers also experience more frequent job losses and less stable hours, putting them especially at risk of losing health coverage due to a work requirement. Even those who would technically meet (or be exempt from) the requirement could still lose health coverage if they get tripped up by the paperwork needed to prove it.
We provide state-by-state data on the top occupations among workers with Medicaid who would likely be subject to the work requirements under the House Republican reconciliation bill, using 2021–2023 American Community Survey data. The House-passed bill only applies to low-income adults eligible through the Medicaid expansion (or those receiving waiver-based, comprehensive coverage in certain states like Wisconsin).
The bill also specifies that parents, guardians, or caretaker relatives of a dependent child are exempt. Since most parents have their children included in their Medicaid household in their initial Medicaid applications, states should be able to automatically exempt most people with children. Therefore, we limit our analysis to Medicaid enrollees aged 19 to 64 without children, who did not receive Medicare or Supplemental Security Income, and who worked within the last year. For North Carolina and South Dakota, which expanded Medicaid in 2023, we provide estimates of the expansion-eligible population without children, which we estimate using the methodology from our estimates of people in the Medicaid coverage gap.[2]
Download spreadsheet: Top Occupations for Medicaid Enrollees Without Children in Expansion States
