Health Reform WK-EDGE Medicaid work requirements a concern for workers in flexible industries
Tuesday, June 18, 2019

Medicaid work requirements a concern for workers in flexible industries

By Kayla R. Bryant, J.D.

Workers with less control over their schedules, such as those in retail and hospitality industries, may have difficulty meeting work requirements for safety net programs.

The low-wage job market is fraught with instability and what the Urban Institute calls "precarious" work schedules, which prevents a problem for participants in programs with strict work requirements. With various states seeking to apply work requirements to Medicaid through the waiver process, plus discussion of bolstering such requirements for the Supplemental Nutrition Assistance Program (SNAP) as well as housing subsidies, concerns about program access are on the rise. According to the Urban Institute, workers with families in safety net programs are more likely to have irregular schedules.

Reduced control. A hallmark of industries with many low-wage jobs is lack of employee control over scheduling due to pressure to reduce costs. Precarious work schedules may be provided with short notice, change quickly, and have an inconsistent number of hours from week to week. Regardless of safety net participation, just over half of workers in low-wage jobs reported little to no input on the days they worked.

About 75 percent of workers surveyed who do not participate in safety net programs have a regular daytime shift schedule, while 58.3 percent of safety net participants worked a daytime shift. Survey results showed that 14.8 percent of workers with family participation in safety net programs were salaried, as opposed to 46.6 percent of those without safety net participation. Over 80 percent of safety net participants reported fluctuation in weekly hours over the last month, many reporting differences of as much as 20 hours per week.

Work requirements. The strictest work requirements in safety net programs are directed toward those without dependent children, although some proposals would apply these requirements to adults with dependents. This causes additional concern about the ability to juggle work and child care and risk of losing benefits for both adults and children. Work requirements also fail to take into account the regular fluctuation of hours from week to week and a participant’s lack of ability to quickly find another job to supplement hours if their main job’s hours are cut without notice. The Urban Institute stated that work requirements would need to be flexible as a counter to the inflexibility of work schedules for safety net program participants in order to be "grounded in this reality."

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