Study finds two-thirds of Missouri Medicaid recipients have jobs
By: Sarah Fentem (STLPR)
Trump Republicans shot this culture war horse to Make America Great Again. Turns out the 'fix' was just another Big Government unfunded mandate that makes the red ink even redder.
S E E D E D C O N T E N T
April 16, 2026 -- Starting next year, many adults who receive benefits from Medicaid, the government-sponsored health coverage program for low-income and disabled people, will need to prove they're working, volunteering or searching for a job.
The federal directive was included in last year's massive spending bill and is designed to foster "agency" and "community engagement" among recipients.
But an analysis of Missouri census data shows that two-thirds of the state's adult Medicaid recipients are already working.
Researchers at the Washington University Center for Advancing Health Services, Policy and Economics Research found Missourians ages 19 to 64 who would be held to the work requirement held full-time (38%) or part-time (29%) jobs. Others who didn't work cited disability, illness, caregiving or retirement as reasons they didn't work.
About 12% of those ages 19 to 64 on Medicaid said they were not working "due to other reasons."
Tim McBride, a professor at the WashU School of Public Health and one of the policy brief's authors, said the requirements will require significant money and manpower to reach a relatively small share of Medicaid recipients who are not working.
"It seems like a lot of staffing and a lot of dollars to be spent on [around] 40,000 people, in my opinion," he said, adding, "I think it comes from a misperception of Medicaid recipients."
Congress last year, as a part of the One Big Beautiful Bill Act, passed work requirements for people within the Affordable Care Act's Medicaid expansion population. To receive federal Medicaid funding, states will need to put a reporting system in place. Medicaid enrollees must work, perform community service or go to school for at least 80 hours a month.
Critics have said the bureaucratic hurdles for reporting could mean otherwise eligible people lose coverage.
State officials have said they're focused on making complying with the reporting requirements as seamless as possible, using user-friendly online portals or existing state documents, such as income data, to verify eligibility without requiring direct contact with recipients.
The proportion of employed Medicaid recipients in MIssouri is roughly similar to that of the nation as a whole. However, 30% of recipients in Missouri live in rural areas, about twice the national rate.
Most recipients have completed high school but not college, or don't have a high school diploma.
The mix of lower educational attainment and rural residency likely makes it more difficult for Medicaid patients to find a job with health coverage, the authors wrote.
"If you're going to say there's a work requirement, then there has to be jobs available, or community engagement volunteer activities," McBride said. "And what we worry about is that they may not be available as readily."
Missouri will likely unveil how the reporting program will work later this year. Federal officials are expected to release more guidelines in the coming months about what they require of states' eligibility reporting programs.
Missouri's legislature is still finalizing its budget, which will clarify how much money the state could ultimately spend to implement the new work requirement.
This session, Missouri lawmakers are considering a bill from Rep. Darin Chappell, R-Rogersville, that would place work requirements for Medicaid in the state's constitution.
Chappell said the initiative would ensure "that we have the wherewithal and the budgetary flexibility to make sure that those dollars go to those individuals who are the most vulnerable among us."
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Hey, fiscal hawks, how much money was saved with this Big Government mandate? And Missouri is a MAGA state, to boot.
As more and more corruption shows 47and family and friends, profiting, enormously from the REAL abuse of the citizens monied, as his family is said to be approaching 5 BILLION in increased wealth sine he again took office. Concentrating on the 'little' people as opposed what this administration and his cabinet have managed to profit off government is crazy. How does Walmart get away with having employees work less than 40 so they still need help with health ins ? This company, as well as many other corporations make Billions, yet, like oil companies and say Tesla, they are somehow able to siphon monies from the public via tax subsidies etc., and it' is just bullship.
The whole concept is dumb and cruel. Why - in the richest country in the world - should a citizen have to prove they are deserving of healthcare? Isn’t it smarter to make sure everyone has basic healthcare without having to jump through a bunch of bureaucratic hoops? Hell, isn’t it just the right thing to do?
When you feed your family at night, do you check with your spouse and children to make sure they worked hard enough to deserve a meal? Or a trip to the doctor if they’re ill? What is the point of so stridently gatekeeping these basic needs?
”Working for an employer” is certainly not the only way a human being contributes to society, or even makes money. Conservatives who push this crap are just trying to justify turning their backs on their brothers and sisters. It’s an excuse to be selfish. And it’s particularly unbecoming of those who claim to be Christians.
Republicans will complain that we can’t afford it. Yes we can.