Work requirements to kick 2.3M young adults off Medicaid, reduce enrollment by 48%, report shows
A left-leaning policy group looking at the impact of looming Medicaid cuts as a result of the 2025 One Big, Beautiful Bill Act said in a new report that young adults are especially likely to feel the new impact of eligibility requirements, mostly related to new work requirements.
According to the Urban Institute, 2.3 million Americans ages 19 to 24 could lose their Medicaid benefits by 2028, leaving them without medical coverage.
The issue is strictly related to the state-specific work requirements, which require beneficiaries to maintain stable employment every week. As the researchers noted, many young adults change jobs frequently, or rely on gig work to pay the bills.
As weekly check-ins for Medicaid eligibility go into effect, that can leave millions unable to prove they meet the threshold established by the federal government.
Even students may struggle, as credit hours change as a normal part of getting a college education and dropping courses, the Urban Institute noted.
Part of the issue will be the way states capture data to prove eligibility. Even up-to-date reports may not capture the true economic conditions of Medicaid beneficiaries, as their lives change from month to month.
On paper, most young adults eligible for Medicaid currently meet the requirements, at an estimated rate of 88% nationwide. But that could change as real-time data clashes with policy minimums for hours worked and class enrollment.
"The extent of Medicaid coverage drops for this group will depend heavily on state data matching capacity and implementation choices,” Jennifer Haley, principal research associate at the Urban Institute, said in a statement.
State-by-state variation
In part, Medicaid enrollment will depend on how states enforce the barriers set by the Centers for Medicare & Medicaid Services. In states with policies favorable to beneficiaries, enrollment may only drop from 9% to 31%. But in more vigilant states, the Urban Institute said loss of coverage could impact young adults at a rate of 22% to 58%.
On average, researchers say Medicaid enrollment among adults under 25 could drop by 48%.
For more, read the full report from the Urban Institute by clicking here.
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