Tipirneni, Goold, and Ayanian write research letter on expanded Medicaid in Michigan

January 3, 2018

Renuka Tipirneni, Susan D. Goold, and John Z. Ayanian published a December 11 research letter in JAMA Internal Medicine on “Employment status and health characteristics of adults with expanded Medicaid coverage in Michigan.”

The study analyzed the employment status of Medicaid enrollees who received coverage under Michigan’s Medicaid expansion. The authors found that more than half of these enrollees were employed or were students. The majority of the remaining enrollees were either unable to work or reported being in poor physical or mental health.

The study comes at a time when the Trump administration is considering enacting work requirements for enrollees to qualify for Medicaid. According to Tipirneni, Goold, and Ayanian, “[T]he proportion of Medicaid expansion enrollees overall who were not working and possibly able to work if employment were available remained small.” They write that states like Michigan should consider “the administrative costs of implementing a work requirement program . . . for relatively few individuals” and “the risk of coverage interruptions for vulnerable individuals” when weighing the decision to implement work requirements.

The authors’ research letter was cited in Margot Sanger-Katz’s January 11 article in the New York Times’ "The Upshot": “Can requiring people to work make them healthier?” Weighing research like the study above, Sanger-Katz writes, "There is not strong evidence" for the contention that work requirements will make Medicaid enrollees healthier.