Work Requirements and Perceived Deservingness of Medicaid

Abstract

Does an individual’s effort to acquire employer-sponsored health insurance through employment affect whether they are deserving of health insurance? Much of the current literature that examines the deservingness of federally-funded health insurance focuses on an individual’s responsibility in becoming ill. However, logic from the welfare literature would suggest the willingness to work for one’s welfare, or reciprocity, is an important determinant of deservingness. The relevance of employment-seeking in Medicaid deservingness comes at a crucial time given recent attempts by state governments to implement work requirements as a part of Medicaid eligibility. Using a series of survey experiments, I compare the importance of responsibility versus reciprocity and find that responsibility, what one does to become ill, is the primary driver of judgments of deservingness. What one does to earn their Medicaid by working plays a negligible role in driving attitudes. These findings have implications for how we understand the determinants of support for Medicaid policy.