Abstract
Work requirements are increasingly common in major public assistance programs, initially implemented in cash support (TANF) and food assistance (SNAP) programs, and starting in 2018 in Medicaid. Proponents of work requirements contend that these policies increase beneficiary engagement in work and community activities and may lead to better health. Opponents of work requirements suggest that many low-resource households will lose much-needed benefits, without commensurate improvements in employment. There is limited evidence on the causal impact of work requirements in modern public assistance programs, even as more than a dozen states have proposed new Medicaid work requirements in the past year. We propose a randomized-controlled trial (RCT) of work requirements in Virginia, leveraging state support for the RCT evaluation. We will be able to separate the causal impact of work requirements from another new feature of Virginia’s Medicaid program: monthly premiums. We will study impacts of both policies on employment, earnings, insurance status, and access to care using a mix of administrative and survey-collected data.