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More than 5M could lose Medicaid coverage if feds impose work requirements

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4 weeks ago

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westvirginiawatch.com – Shalina Chatlani – 2025-04-02 05:00:00

by Shalina Chatlani, West Virginia Watch
April 2, 2025

Under an emerging Republican plan to require some Medicaid recipients to work, between 4.6 million and 5.2 million adults ages 19 to 55 could lose their health care coverage, according to a new analysis.

The study, conducted by Urban Institute researchers with support from the Robert Wood Johnson Foundation, calculated that up to 39% of the 13.3 million adults in that age group who became eligible for Medicaid when their states expanded the program under the Affordable Care Act would lose coverage if Congress required states to impose work rules.

The report suggests that most of those people would lose coverage not because they aren’t complying with the rules, but because they would struggle to report their compliance to the state.

“Most adults who would lose eligibility for federal Medicaid funding are working, engaged in work-related activities, or could qualify for exemptions not readily identifiable through state databases but could still face disenrollment because of the reporting requirements,” it states. The study identified several barriers to reporting, including lack of broadband access and lack of transportation.

Forty states plus the District of Columbia have expanded Medicaid under the ACA. Overall, nearly 72 million people, about a fifth of Americans, are enrolled in the program for low-income people, which is funded jointly by the federal government and the states.

Traditional Medicaid insurance was mainly available to children and their caregivers, people with disabilities and pregnant women. But the ACA, commonly known as Obamacare, allowed states to extend coverage to adults making up to 138% of the federal poverty level — about $21,000 a year for a single person.

Nationwide, more than 21 million people with low incomes have health insurance because of expanded Medicaid eligibility.

U.S. House Republicans in February pushed through a budget plan, now under consideration in the Senate, that would require about $880 billion in cuts to Medicaid over the next decade to help cover the cost of $4.5 trillion in tax cuts. The budget doesn’t contain specifics on how that target would be met. But work requirements are a likely money-saving option: A 2023 analysis from the nonpartisan Congressional Budget Office found that imposing work rules on Medicaid recipients ages 19 to 55 who are not parents or caregivers would cut federal spending by an estimated $109 billion over the next 10 years.

The Congressional Budget Office based that projection on a plan the GOP-controlled U.S. House approved in 2023. That bill, the likely blueprint for the work requirements Republicans are considering now, would have required adults ages 19-55 to work, participate in a job training program or perform community service for at least 80 hours per month for three or more months in a calendar year. Parents and caretakers of dependent children, and those unable to work because of a health condition, would have been exempt.

Many Republican-led states are eager to impose work requirements on able-bodied Medicaid recipients. Thirteen states received permission to impose work rules on at least some Medicaid enrollees during the first Trump administration. Nine additional states requested permission to enact Medicaid work requirements during Trump’s earlier term but had not won approval by the time it ended.

When the Biden administration came into office, it rescinded all the approvals.

Supporters say requiring Medicaid recipients to work, study or train for a career gives them a boost toward self-sufficiency and financial stability. Critics, however, say such rules end up hurting far more people than they help.

The researchers from the Urban Institute mostly based their analysis on the experience of Arkansas, which in June 2018 became the first state to require some Medicaid recipients to work, volunteer, go to school or participate in job training to receive benefits. By the time a federal judge halted the policy in April 2019, 18,000 adults had lost coverage.

The researchers also looked at New Hampshire, which began implementing a work requirement but halted the program in July 2019 before suspending anyone’s coverage.

“What was found in a lot of qualitative research on the previous work requirement programs is that a lot of people were unaware of the policy, or they didn’t understand the policy,” said Michael Karpman, an Urban Institute researcher who co-authored the study.

“People who need coverage the most would do the most to try to maintain it. On the other hand, those people could also face the most difficulty with the administrative barriers,” Karpman said.

In a 2020 study examining how Arkansas’ last experience with work requirements played out, researchers from the Harvard T.H. Chan School of Public Health “found no evidence that the policy succeeded in its stated goal of promoting work and instead found substantial evidence of harm to health care coverage and access.”

Arkansas Republican Gov. Sarah Huckabee Sanders announced in January that she would ask the federal government for permission to institute work requirements, regardless of what Congress decides. The state submitted the request last week.

Especially for a rural state like Arkansas, work requirements fail to take into account a lot of the realities that people may face.

– Christin Harper, policy director for Arkansas Advocates for Children and Families

Arkansas Republican state Rep. Aaron Pilkington, who serves on the health committee in his chamber, said lawmakers “learned our lesson from the last go-round.”

Pilkington said that under the new proposal, the state will only pause coverage instead of canceling it, giving recipients an opportunity to prove they are complying. And, he said, the online portal for reporting will be a lot more user-friendly.

“I think it’s a reasonable thing to ask for able-bodied people to look for work, or try to obtain work,” Pilkington said.

But Christin Harper, policy director for Arkansas Advocates for Children and Families, said even the new version would be a challenge for many enrollees. Many people on Medicaid are juggling multiple jobs, and having to report to the state every month would be a significant burden.

“Especially for a rural state like Arkansas, work requirements fail to take into account a lot of the realities that people may face,” Harper said. She added that “with the overall job market, job opportunities may or may not be available in some of these rural towns.”

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

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West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.

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University of Pikeville adding dental school to help address the needs of rural Appalachia

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7 hours ago

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May 1, 2025

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www.youtube.com – WCHS Eyewitness News – 2025-05-01 15:00:30

SUMMARY: The University of Pikeville is constructing a dental school to address the critical shortage of dentists in rural Appalachia, particularly in eastern Kentucky. The program will allow students to complete their studies in three years instead of four, reducing costs and quickly preparing them for the workforce. The school’s location aims to fill the gap created by a decrease in dentists in rural areas, where many patients face long waits or must travel for care. A $2 million donation from Delta Dental of Kentucky will support equipment, scholarships, and tuition assistance. The dental school is set to open in June 2026.

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PIKEVILLE, Ky. (WCHS) — Construction is underway for a dental school at the University of Pikeville which is expected to have a positive impact on students and rural Appalachian residents.

FULL STORY: https://wchstv.com/news/local/university-of-pikeville-adding-dental-school-to-help-address-the-needs-of-rural-appalachia#

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News from the South - West Virginia News Feed

Company preserving WV's past with reclaimed wood

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1 day ago

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April 30, 2025

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www.youtube.com – WCHS Eyewitness News – 2025-04-30 15:00:35

SUMMARY: Barewood Company in Hurricane, West Virginia, started 11 years ago by owner Matt Snider, a woodworker with 30 years of experience. He left a stable job to create a business using reclaimed wood from local historic sites. One notable piece came from a barn in Hamlin, which remained unchanged despite shifts in county and state lines. Barewood crafts products from wood sourced from old businesses, barns, and even bowling alleys, incorporating live edge, epoxy, and bourbon barrel heads. With locations in Hurricane, Charleston, and Morgantown, the company preserves West Virginia’s history through its unique, story-rich wooden creations.

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PUTNAM COUNTY, W.Va. (WCHS) — In a sawdust-filled building in Hurricane, West Virginia, you find Bear Wood Company — an idea that started 11 years ago in a garage.

Owner Matt Snyder said he has been a woodworker for about 30 years, but took a leap in making it his full-time career.

FULL STORY: https://wchstv.com/news/local/bear-wood-company-looks-to-build-bonds-while-preserving-the-past-of-the-mountain-state

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News from the South - West Virginia News Feed

FEMA’s refusal to help some West Virginia counties just a taste of what’s to come

Published

3 days ago

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April 29, 2025

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westvirginiawatch.com – Leann Ray – 2025-04-29 04:55:00

by Leann Ray, West Virginia Watch
April 29, 2025

Last week, West Virginia Watch reporter Amelia Ferrell Knisely traveled to McDowell County to talk to residents about recovery efforts after the mid-February floods.

She found that many people still have soggy carpets and wet basements after more than two months. Houses are filled with mold. Trash is piled up outside. Some residents say they haven’t seen anyone from the state or federal government in their small towns offering help.

And McDowell is one of the few counties that actually received federal funding for flood response. 

In late February, the federal government approved Gov. Patrick Morrisey’s request for federal  aid. The Federal Emergency Management Agency has so far approved nearly 3,500 applications for individual assistance, and more than $25 million has been awarded to residents in Logan, McDowell, Mercer, Mingo, Raleigh, Wayne and Wyoming counties.

Residents who receive that money can use it to cover the costs of temporary housing and home repairs. 

About 94% of West Virginia communities are considered “Special Flood Hazard Areas,” which means the more than 84,000 structures in those areas are at a high risk of flooding, according to a 2023 report by researchers at West Virginia University.

However, President Donald Trump has suggested that FEMA, which is the only agency currently that administers disaster relief funds, might “go away.”

Last week it was announced that Elon Musk’s Department of Government Efficiency would cut 1,000 employees — or 20% of the workforce — from FEMA, just ahead of hurricane season.

On Wednesday, Morrisey announced that FEMA denied individual assistance grants to Boone, Cabell, Greenbrier, Kanawha, Lincoln, Monroe and Summers counties, and public assistance grants in Cabell and Kanawha counties for the February floods. 

“Despite today’s notification, I am grateful to the Trump Administration for their strong support for Southern West Virginia’s recovery following the February floods,” Morrisey said in a statement. 

We know you’re not a native West Virginian, governor, but please stand up for your adopted state.

Alex Brown from Stateline, one of West Virginia Watch’s sister newsrooms, reached out to the White House about states being denied FEMA funding, and received a statement that said the agency is focused on “truly catastrophic disasters,” and that states need to have a better “appetite to own the problem.”

West Virginia has no appetite, as shown during the legislative session.

On April 4, about three weeks after the devastating February floods, Del. Sean Hornbuckle, D-Cabell, proposed adding $50 million to the state budget for flood prevention. 

“We have the ability to do something earthly,” Hornbuckle said. “The power that we have — not just the divine power — but with a button and a pen that we all have to help out neighbors in the great state of West Virginia.”  

The amendment was rejected 75-19.

Remember the 2016 floods — the deadliest in the state’s history? Former Gov. Earl Ray Tomblin, a Democrat born in Logan County, declared a state of emergency for 44 of the state’s 55 counties.

Since November 2019, FEMA has given West Virginia more than $424 million in funding in response to the 2016 floods. More than $42 million was given to 4,949 individuals and families, and more than $172.8 million was given to local and state governments and some nonprofits. FEMA also provided more than $209.8 million to replace Herbert Hoover High, Richwood Middle, Richwood High, Summersville Middle and to relocate Clendenin Elementary.

Herbert Hoover High School was destroyed, and students were taught in portable classrooms until their new school was completed in fall 2023. Clendenin Elementary School didn’t reopen until fall 2024. Construction hasn’t started on the schools destroyed in Nicholas County. 

In response to that flood, the West Virginia Legislature created the State Resiliency Office. Its purpose is to “Minimize the loss of life and property, m​​aintain eco​nomic stability, and improve recovery time by coordinating with stakeholders to implement disaster resilient strategies.​​

The state Legislature created the West Virginia Disaster Recovery Trust Fund in 2023 with Senate Bill 677. The fund sits empty. No money was allocated to that fund during the 2024 legislative session. The FY 2026 budget, which Morrisey has signed, doesn’t include any money for the fund either. 

There were only three bills related to flooding during the session — House Bill 2858 and Senate Bill 502 were the same bill, meant to allow counties to regulate floodplains under National Flood Insurance Program guidelines. They both died. House Bill 3502, sponsored by Hornbuckle, would have allowed a one-time allocation of $100 million from the state revenue shortfall fund and $150 million from the state’s income tax revenue fund for the West Virginia Flood Resiliency Trust Fund. It died in the House Government Organization.

West Virginia needs FEMA, but with FEMA potentially out of the picture, it’s time the state whet its appetite and take a bite out of the problem. 

Morrisey has already said he plans to call a special session this summer to deal with the Public Employees Insurance Agency and education funding. Sounds like the perfect time and a good use of tax payer money to move some funding over to the West Virginia Disaster Recovery Trust Fund.

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West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.

The post FEMA’s refusal to help some West Virginia counties just a taste of what’s to come appeared first on westvirginiawatch.com


Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This content reflects a center-left political bias as it highlights government and federal aid shortcomings in disaster response and recovery, particularly criticizing Republican leadership and policies, such as those associated with former President Trump and West Virginia Governor Morrisey. It underscores the need for more proactive state intervention and funding to support vulnerable communities, especially in the context of disaster resilience. The critique of budget decisions and FEMA staff cuts aligns with a perspective that supports stronger public sector involvement and social responsibility, typical of center-left viewpoints, without veering into extreme or partisan language.

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