Work Requirements and Medicaid: What Will Happen to Beneficiaries with Mental Illnesses or Substance Use Disorders?

Commonwealth Fund’s The Q&A

By Martha Hostetter & Richard G. Frank

Kentucky, Indiana, and Arkansas have received approval from the Centers for Medicare and Medicaid Services (CMS) to add work or service requirements to their Medicaid programs; seven other states are seeking such waivers. In their recent article “Work Requirements in Medicaid for People with Mental Illnesses and Substance Use Disorders” (Psychiatric Service, Apr. 13, 2018), Richard G. Frank, Margaret T. Morris Professor of Health Economics at Harvard Medical School, and Sherry A. Glied, dean of the Robert F. Wagner Graduate School of Public Service of New York University, raised concerns about how such requirements might affect Medicaid beneficiaries with mental illnesses or substance use disorders. We spoke with Frank about the challenges of determining whether someone is able to work and what happens when people with mental illnesses are denied critical benefits.

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