(1) The vast majority of enrollees are children or otherwise exempt. Medicaid covers about 1 million Alabamians (roughly one in every five people in the state), and most of them are children. Almost all of the rest are seniors, pregnant women, or people with disabilities who would be exempt from work requirements. Only about 7.5 percent of enrollees – roughly 75,000 people in the “parent and other caretaker relative” category – could be subject to a requirement.

(2) Many Alabamians who would face work requirements have serious barriers to employment. Nearly 90 percent of the 75,000 parents and caretakers covered by Alabama Medicaid are women. Many are going to school or caring for young children at home. Medicaid work requirements would not make child care, transportation or job training more accessible for them.

(3) Adults who lose Medicaid would fall into the coverage gap. Most states seeking to impose work requirements have expanded Medicaid for working-age adults. But Alabama hasn’t. About 300,000 Alabama adults are caught in a coverage gap. They earn too much for Medicaid but too little to receive subsidies for Marketplace coverage.

(4) Work requirements would create a catch-22 for people in poverty. Alabama parents can’t qualify for Medicaid if their income is above 18 percent of the poverty line. Someone working just 20 hours a week at minimum wage earns too much to qualify for Medicaid in Alabama. It’s unfair to require people to work to keep health coverage, only to take it away when they do.

By Chris Sanders, communications director, and Jim Carnes, policy director. Last updated Jan. 26, 2018.