Association for Public Policy Analysis & Management

Several states are implementing community engagement requirements (“work requirements”) in Medicaid, though legal challenges remain. While most low-income individuals work, it is less clear how many engage in the required number of hours of qualified community engagement activities, and what heterogeneity may exist by race/ethnicity, age, and gender. We analyzed national time-use survey data from the U.S. Census to estimate current levels of employment and other community engagement activities among potential Medicaid beneficiaries. We found that low-income adults who might become subject to Medicaid work requirements already spent an average of 29 hours per week on work, volunteering, education, and caregiving for the elderly/disabled. However, 49 percent of our low-income sample – particularly women, older adults, and those with less education – would not currently satisfy a 20-hour-per week requirement and could therefore be at risk for losing coverage.