KDHE’s KanCare extension application in December 2017 proposed adding work or community engagement requirements to currently eligible adults who are not pregnant, disabled, in long-term care, age 65 and older, or providing care for young children, older adults or people with disabilities in the household. The criteria for meeting the proposed work or community engagement requirements closely track with current requirements for the Temporary Assistance for Needy Families (TANF) program in Kansas, but there are differences.
For Medicaid in Indiana, Kentucky and Arkansas, the approved requirements for hours engaged in work activities was 20 hours a week (or 80 hours a month in Kentucky and Arkansas), but this analysis uses a standard of 30 hours a week as a proxy for Kansas’ proposed Medicaid work requirement, approximating the Kansas TANF criteria.
To receive TANF cash assistance in Kansas, the minimum weekly requirements for work activities are 20 or 30 hours in a one-adult household, depending on whether there is a child under age 6. However, in the KanCare application, an adult caring for a child under age 6 would be exempt from the requirements entirely. (TANF minimum weekly requirements are 35 or 55 hours in two-parent households, depending on whether state-subsidized child care is provided.) Kansas officials have said they expect about 12,000 adults currently enrolled in KanCare—primarily parents with children over age 6—would be subject to the work requirements as proposed.
The TANF criteria are more complex than can be mirrored precisely using ACS data. To provide a high-level picture of the potential effect of a work requirement if KanCare were expanded, this analysis assessed how many likely new enrollees work, and how many work at least 30 hours per week.
Of the approximately 95,000 adults projected to newly enroll in KanCare if expanded, nearly 64,000 (or roughly two-thirds) were employed at some point in the previous 12 months. Of those 64,000 adults, just over 26,000 worked at least 30 hours per week year-round (for at least 50 weeks in the year) (Figure 3).
Another approximately 11,000 of the 95,000 projected new adult enrollees would meet or be exempt from work requirements because they are caring for a child under age 6, or because they are in a two-adult household that meets the work requirement.
Some of the remaining adults (nearly 58,000) also might be exempt from work requirements—for example, if pregnant, determined disabled by Social Security standards, or caring for an older adult in the home. Others may meet community engagement requirements by volunteering, seeking a General Education Degree, enrolling in vocational education or job readiness programs, or serving in supervised community service, among other activities. In addition, the KanCare extension application proposed grace periods of up to three months for adults not exempt from the requirements.