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Enrollees Who Work Still Need Medicaid, Kaiser Survey Shows


Over the weekend, White House adviser Kellyanne Conway defended cuts to Medicaid that are outlined in the Senate Republican health care bill. She was on ABC's "This Week," and she said that Medicaid enrollees who are, quote, "able bodied" should be able to find jobs and get health care through their employers.


KELLYANNE CONWAY: If they're able-bodied and they want to work, then they'll have employer-sponsored benefits like you and I do.


MARTIN: So this isn't exactly a new argument, but Diane Rowland of the Kaiser Family Foundation says there are big holes in it, mainly this one.

DIANE ROWLAND: Well, we know that many of the people on Medicaid are already working, many of the adults who are able to go out and get a job, if they can. But we also know that those jobs often do not come with health insurance benefits. And these are very low-income people who, even when they work, could probably not even afford the coverage if their employer offered it.

MARTIN: Diane, do you have any stats on this? Do you have any idea how many people on Medicaid are employed?

ROWLAND: Well, of the individuals who are adults on Medicaid who do not qualify on the basis of their disability status, we know that 41 percent of them are already working, and another 15 percent of them have part-time jobs. So they're just not getting health insurance benefits with their jobs.

MARTIN: You - your background is in Medicaid. You've worked in the Medicare system and in health policy. What can you tell us about the typical profile? Is there a typical profile of someone who's on Medicaid?

ROWLAND: Many of the adults that are covered under Medicaid really are very disabled or ill. About 35 percent of the non-working adults on Medicaid say that they're ill or disabled, another 28 percent taking care of family members. So when people are on Medicaid and not working, it's usually either because they can't find a job - which is a small share - but more likely that they're in school, that they're trying to take care of a child or an elderly adult or that they themselves are ill or disabled.

MARTIN: So how do you respond, then, when you hear someone like White House adviser Kellyanne Conway saying they just have to get a job, otherwise they wouldn't need these government benefits?

ROWLAND: I think many people do not understand what it's like to be low-income. These are some of the, quote, "forgotten people" who are really struggling to just be able to keep food on their table, to keep their families together and for whom having health insurance coverage can make the difference between life and death.

If they could go out and get a job and get the kind of health insurance benefits that Kellyanne Conway and I can get from the jobs we have, then I think they would be very happy. But their jobs don't always come with that kind of coverage.

MARTIN: What will be the effect of the Senate Republican bill, if it goes through, on this population, do you think?

ROWLAND: I think if the Senate bill goes through, that this population will again return to the ranks of the uninsured and that we will see them less able to work because they'll lose their health insurance coverage that helps get them access to care so that they can continue to work. And I think we'll see a return to hospital emergency rooms being swamped by uninsured people who, unfortunately, wait too long to get the health care they need and often end up sicker. And sometimes we let people have conditions that could have been treated lead to their early deaths.

MARTIN: Diane Rowland is with the Kaiser Family Foundation. Thanks so much for talking with us.

ROWLAND: Thank you.

(SOUNDBITE OF SONG, "TIME") Transcript provided by NPR, Copyright NPR.