I am writing to express my opposition to any legislation or policy proposals that would impose work requirements on Medicaid enrollees. Evidence from states that have implemented such requirements demonstrates that these policies do not achieve their stated goals and instead harm vulnerable populations.
In Arkansas, over 18,000 people lost Medicaid coverage within nine months of work requirements taking effect, with no corresponding increase in employment. Many who lost coverage faced delays in medical care, skipped essential medications, and incurred medical debt due to the loss of insurance. Similarly, Georgia’s Pathways to Coverage program—which mandates 80 hours of monthly work for eligibility—enrolled only 7,000 people as of March 2025, far below the projected 100,000, largely due to burdensome reporting rules.
Work requirements create administrative complexity and costs for North Carolina while failing to address barriers to employment, such as lack of childcare or transportation. Data shows that most Medicaid enrollees are already working, caregiving, or facing health challenges that exempt them from such requirements. Adding bureaucratic paperwork to qualify just creates work that requires more state employees.
I urge you to reject any measures that tie Medicaid eligibility to work requirements and instead support policies that expand access to healthcare and address systemic barriers to employment. Thank you for your attention to this critical issue.
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