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House Republicans’ Medicaid Cuts and Associated Lives Lost by Congressional District [1]

['Natasha Murphy', 'Andrea Ducas', 'Associate Director', 'Media Relations', 'Senior Director', 'Government Affairs']

Date: 2025-05

House Republicans’ radical new budget plan proposes requiring states to implement Medicaid work reporting requirements for adults enrolled through the Affordable Care Act’s (ACA) Medicaid expansion. Under this proposal, nonpregnant, nondisabled, noncaregiver adults ages 19 to 64 would be required to document at least 80 hours per month of work or qualifying activities (such as volunteering) in order to maintain their Medicaid coverage. Otherwise, they would need to seek approval for a qualifying exemption.

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Nearly everyone with Medicaid coverage who is able to work already is. Data from KFF shows that 92 percent of adult Medicaid enrollees in 2023 were either working; in school; serving as a caregiver; or unable to work due to illness or disability. As a result, evidence from prior state-level implementations show that bureaucratic paperwork requirements do not increase employment but do result in large-scale coverage losses—even among those who are working or should be exempt from the requirements. Work reporting requirements would have an outsized impact on women, the vast majority of whom work full- or part-time or have caregiving responsibilities that should allow them to be exempt.

In some districts, such as Nevada’s 2nd Congressional District and New York’s 11th Congressional District, the annual death toll could reach into the hundreds as a result of House Republicans’ proposed Medicaid work reporting requirements.

The consequences of such coverage losses, however, are not just administrative: For thousands of Americans, they would be deadly. New estimates from the Center for American Progress show that 6.9 million people losing coverage by 2034 as a result of congressional Republicans’ proposed paperwork requirements would lead to more than 21,600 avoidable deaths nationally each year. This translates to lives lost in every congressional district with Medicaid expansion enrollees. In some districts, such as Nevada’s 2nd Congressional District and New York’s 11th Congressional District, the annual death toll could reach into the hundreds as a result of House Republicans’ proposed Medicaid work reporting requirements.

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5 Facts About Medicaid Work Requirements Article April 25, 2025 5 Facts About Medicaid Work Requirements Natasha Murphy

Work reporting requirements would cost lives According to estimates from the Center on Budget and Policy Priorities (CBPP), if Congress imposes paperwork requirements for Medicaid expansion enrollees ages 19 to 64*, 6.9 million people across Medicaid expansion states would lose coverage by 2034. CBPP based these estimates on Arkansas’ experience implementing paperwork requirements and assumed that 72 percent of expansion enrollees not automatically exempted would lose coverage due to the policy. CBPP’s analysis also assumes that parents would be exempt. A 2017 study by health economist Benjamin D. Sommers found that Medicaid expansion was associated with “one life saved annually for every 239 to 316 adults gaining insurance.” Applying the more conservative end of Sommers’ range to CBPP’s coverage loss projections, CAP estimates that imposing work reporting requirements as proposed by the House Energy and Commerce bill would lead to avoidable deaths in each congressional district with Medicaid expansion enrollees—as many as hundreds in some. For example, each year, 212 avoidable deaths would occur in Nevada’s 2nd Congressional District; 187 avoidable deaths would occur in Delaware’s only congressional district; and 130 avoidable deaths would occur in New York’s 11th Congressional District.

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[1] Url: https://www.americanprogress.org/article/house-republicans-medicaid-cuts-and-associated-lives-lost-by-congressional-district/

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