Chronic Disease, Functional Limitations, and Workforce Participation Among Medicaid Enrollees Over 50: The Potential Impact of Medicaid Work Requirements Post-COVID-19.
Rodlescia S Sneed, Alexander Stubblefield, Graham Gardner, Tamara Jordan, Briana Mezuk
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引用次数: 0
Abstract
From 2018-2020, 19 states enacted Medicaid work requirements as a strategy for reducing program enrollment and overall cost. While these requirements were later rescinded, strategies to reduce Medicaid costs are likely to reemerge as states attempt to recover economically from the COVID-19 pandemic. Here, we evaluated the impact of Medicaid work requirements on adults aged > 50, a group that likely faces significant age-related chronic disease burden. Using 2016 Health and Retirement Study data, we evaluated the chronic disease burden of adult Medicaid beneficiaries aged 51-64 years (n = 1460) who would be at risk of losing their Medicaid coverage due to work requirements. We compared Medicaid beneficiaries working <20 hours per week (i.e. those at risk of coverage loss) to those working at least 20 hours per week on eight chronic health conditions, adjusting for demographic characteristics. Among those with chronic health conditions, we also evaluated differences in disease severity based on hours worked per week. Among those working fewer than 20 hours per week, odds of disease were greater for seven of eight chronic conditions, including history of stroke (OR: 5.66; 95% CI: 2.22-14.43) and lung disease (OR: 3.79; 95% CI: 2.10-6.85). Further, those with greater disease severity were likely to work fewer hours. Thus, the introduction of Medicaid work requirements would likely result in coverage loss and lower access to care among older Medicaid beneficiaries with multiple chronic health conditions.
期刊介绍:
The Journal of Aging & Social Policy offers a platform for insightful contributions from an international and interdisciplinary group of policy analysts and scholars. It provides an in-depth examination and analysis of critical phenomena that impact aging and the development and implementation of programs for the elderly from a global perspective, with a broad scope that encompasses not only the United States but also regions including Europe, the Middle East, Australia, Latin America, Asia, and the Asia-Pacific rim.
The journal regularly addresses a wide array of issues such as long-term services and supports, home- and community-based care, nursing-home care, assisted living, long-term care financing, financial security, employment and training, public and private pension coverage, housing, transportation, health care access, financing, and quality, family dynamics, and retirement. These topics are of significant importance to the field of aging and social policy, reflecting the journal's commitment to presenting a comprehensive view of the challenges and solutions related to aging populations around the world.