Disabled workers are less likely to have employer-sponsored health insurance, placing them at increased risk of losing coverage when Medicaid work requirements take effect next year, according to a report published by the Center for Economic and Policy Research.
Coverage gaps for disabled workers
The study found that 57.9% of people with disabilities had employment-based health insurance coverage, compared with 70.6% of people without disabilities. That gap leaves disabled workers more dependent on public health programs.
Disabled workers were significantly more likely than their nondisabled counterparts to rely on Medicaid. Many of them do not currently meet the minimum hours required to maintain eligibility under the federal program once new work requirements begin.
The disparity in employer-sponsored coverage stems from multiple factors. Workers with disabilities often encounter employers who are reluctant to offer benefits or who limit hours to avoid triggering certain thresholds. Additionally, many disabled individuals work part-time or in positions that traditionally offer fewer benefits. Some employers may view the accommodation requirements of the Americans with Disabilities Act as a financial burden, consciously or unconsciously steering disabled applicants toward roles without health coverage options. This employment pattern creates a cycle where those who most need full health benefits are least likely to obtain them through their jobs.
The nature of many disabilities also makes consistent full-time work challenging. Chronic conditions may require frequent medical appointments, treatments, or periods of rest that conflict with rigid work schedules. Some disabilities involve unpredictable symptom flare-ups that make maintaining steady employment difficult. Workers managing conditions such as autoimmune disorders, chronic pain syndromes, or mobility limitations often find that employers are unwilling to accommodate scheduling needs or the flexibility required to manage their health alongside work responsibilities.
Related: Pediatricians welcoming vaccine-skeptical parents
Upcoming policy changes
Medicaid work requirements are set to take effect next year. The policy will require beneficiaries to complete a certain number of work hours monthly to remain enrolled. Critics have raised concerns about how such requirements affect vulnerable populations, including those with disabilities who face higher barriers to employment.
The report did not specify what percentage of disabled Medicaid recipients would fail to meet the new hour thresholds. Researchers noted that disabled workers often face additional challenges in securing consistent employment that provides adequate hours.
For disabled individuals, the intersection of health needs and work obligations creates particular vulnerability. Many receive Medicaid because their disabilities prevent them from working at all or limit their capacity to work consistently. When work requirements mandate a minimum number of hours, these individuals must handle the additional burden of documenting their compliance while managing health conditions that may already consume significant time and energy. The administrative process of verifying work hours or reporting exemptions itself requires understanding complex regulations and potentially communicating with multiple agencies, which can be particularly challenging for those with cognitive disabilities or those who lack stable housing or communication resources.
Advocates point out that losing Medicaid coverage would be especially harmful for disabled workers because their health needs tend to be more extensive and more costly than those of the general population. Employer-sponsored plans available to them may not cover the specialists, therapies, or medications their conditions require. Some disabled workers who do have access to employer coverage report that the plans offered have limited networks, high deductibles, or insufficient coverage for durable medical equipment and assistive devices that their treatment depends upon.
The shift in eligibility requirements also raises questions about how states will implement verification systems and what support services will be available to help disabled beneficiaries document their status or find employment that meets the new criteria. Without adequate infrastructure to identify who qualifies for exemptions or accommodations, researchers fear that many disabled individuals could lose coverage simply due to administrative barriers rather than actual failure to meet substantive work requirements.