Despite recent legal setbacks, the Trump administration continues to advance work requirements (PDF) in federal health, nutrition, and rental assistance programs. These policies typically require participants in safety net programs to work or participate in work-related activities for a minimum number of hours per week or per month to continue receiving benefits.
Underlying such policies are two key assumptions:
- Work requirements will stimulate employment among people who are able but unwilling to work.
- Workers subject to these requirements can control how many hours they work each week.
Drawing on new survey data, two recent Urban Institute briefs suggest the labor market realities facing adults who rely on safety net benefits are more complex. Both analyses find that most of these adults work, but many face barriers to stable employment over time, including just-in-time scheduling practices prevalent in the low-wage job market that often make work hours inconsistent and unpredictable.
Barriers to sustained employment
The first brief, drawing on data from the September 2018 and March 2019 Health Reform Monitoring Survey (HRMS), assesses barriers to sustained employment among nondisabled adults targeted by Medicaid work requirements (i.e., potentially nonexempt).
Though more than 60 percent of these adults reported working during the past year, only 15 percent said they worked 20 or more hours per week for all or nearly all weeks, and another 19 percent usually worked that many hours for most weeks. Many nonexempt adults would therefore be at risk of losing Medicaid in states with work requirements that generally require 20 hours per week or 80 hours per month of work or community engagement.
These work patterns reflect various barriers that many adults with Medicaid must overcome to secure stable employment. Some of these barriers can make it difficult to find work or get to a job, while others constrain the amount or type of work they can do. More than one in four potentially nonexempt Medicaid enrollees reported having multiple chronic health conditions, which can limit many kinds of physical labor.
Among those who did not work at least 20 hours per week on a sustained basis, half cited labor market reasons (e.g., difficulty finding work, employer restrictions on work schedules) for not working more weeks or hours, and more than one in four cited health reasons.
These findings not only indicate that most adults with Medicaid work, but they also suggest that many of these adults lack stable employment because of barriers to work, rather than a lack of will. The findings further suggest that significantly increasing employment among adults with Medicaid would require substantial new investments in education and training, employment services, and work supports. Yet states cannot use Medicaid funding to provide these supports, and no new federal funds have been appropriated.
Precarious work schedules
The second brief highlights the precarious work schedules of adults whose families participated in safety net programs (Medicaid or other public coverage, the Supplemental Nutrition Assistance Program, the Temporary Assistance for Needy Families program, or rental assistance) in the past year, based on data from the December 2018 Well-Being and Basic Needs Survey.
Program participants must navigate work requirements within a low-wage job market characterized by volatile scheduling practices. In an effort to minimize labor costs, firms—aided by just-in-time scheduling software—seek to carefully match employee work hours to projected customer demand. Workers in these firms often see their shift times and number of hours fluctuate (PDF) widely from week to week and receive their work schedules with only a few days’ notice, with schedules sometimes adjusted throughout the day.
Consistent with the HRMS data and other studies (PDF), most of the safety net participants in our sample were working. Most of these workers were paid by the hour, earned low incomes, and usually worked 20 or more hours per week.
But the data underscore the precarious nature of these workers’ schedules. Many work nonstandard shifts, have unstable numbers of weekly hours, get limited advance notice of their work schedules, and have minimal control over their work hours. Notably, these precarious work schedules are most prevalent among safety net participants who do not live with dependent children and are therefore most likely to be subject to work requirements. Yet many parents living with children also face unstable and unpredictable schedules, and work requirements may exacerbate problems coordinating these schedules with child care arrangements.
Misalignment of work requirements with the realities of low-wage work
These two studies challenge the assumptions that work requirements will spur employment among people unwilling to work and that safety net participants have control over how much they work on a week-to-week basis.
Instead, rigid work requirements will clash with the complex realities of the low-wage labor market and the lives of those who participate in it. The recent legal challenge to Medicaid work requirements in Arkansas illustrates how this complexity manifests in the health and employment status of the plaintiffs who must navigate the new work rules, who include:
- a 37-year-old man who lost a job after he began having seizures at work, has limited computer literacy, and lacks his own transportation
- a 42-year-old woman with anemia whose work hours fluctuate based on the amount of work available and who sometimes has only a day’s notice of a reduction in scheduled hours
- a 40-year-old construction worker who recently had tumor surgery and who does not expect to get 80 hours of work each month
These people exemplify how barriers to employment and volatile work schedules make it difficult for safety net participants to consistently comply with these new work requirements, placing them and their families at risk of losing vital health, nutrition, and housing benefits for reasons beyond their control.
Investment in proven workforce development strategies (PDF) is likely to be more effective in increasing employment among adults needing safety net supports while avoiding the risk of increasing material hardship for them and their families.