Internists Oppose Medicaid Eligibility Restrictions Based on Employment

Statement attributable to:
Jack Ende, MD, MACP
President, American College of Physicians

Washington, DC (January 11, 2018)—The American College of Physicians (ACP) is strongly opposed to making access to health care coverage through Medicaid conditional on an individual’s employment status.   A newly announced policy from the Centers for Medicare and Medicaid Services (CMS) provides guidance to states on how they may proceed in imposing work requirements on Medicaid recipients.

Medicaid was designed as a health care program, to provide vulnerable members of our society with access to care they badly need. Work requirements impose an additional, unnecessary barrier to allowing patients access to vital health care services for people who need access and coverage the most.

A recent analysis  by the Kaiser Family Foundation shows that while 80 percent of Medicaid enrollees are in working families and a majority are working themselves, among the adult Medicaid enrollees who were not working, most report major impediments to their ability to work. The analysis noted that, More than one-third of those not working reported that illness or disability was the primary reason for not working. . . nearly nine in ten (88%) non-SSI Medicaid adults who report not working due to illness or disability has a functional limitation, and more than two-thirds (67%) have two or more chronic conditions such as arthritis or asthma. 30% of non-working Medicaid adults reported that they did not work because they were taking care of home or family; 15% were in school; 6% were looking for work and another 9% were retired. Women accounted for 62% of Medicaid enrollees who were not working in 2016, and parents with children under the age of 6 accounted for 17%.”

In ACP’s paper, Medicaid Expansion: Premium Assistance and Other Options, we argue that assistance in obtaining employment, such as through voluntary enrollment in skills- and interview-training programs, can appropriately be made available however it should not be a requirement for Medicaid eligibility.

Medicaid is a critical piece of our country’s health care system.  We need to work together to find ways to improve the program, instead of restrict it, so that it better provides health care coverage to those who need it.


About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

Contact: Jackie Blaser, (202) 261-4572,