Myth Busting Monday: “Medicaid is only for people who don’t work.”

Myth:
Medicaid is only for people who don’t work.

This belief shows up often — sometimes as criticism, sometimes as confusion. It rests on the assumption that public health coverage is separate from the workforce, that Medicaid exists primarily for people outside of employment.

But that assumption doesn’t reflect how the labor market actually functions.

Many people enrolled in Medicaid are working. Some work full-time. Others piece together multiple part-time jobs, seasonal shifts, or contract work. What they share is not a lack of effort — it’s a lack of access to affordable coverage through their wages and hours.

Employer-sponsored insurance is not universally available. Some jobs don’t offer it at all. Some offer plans with premiums or deductibles that consume too large a share of income to be realistic. And in many hourly roles, employers set schedules that rise and fall week to week. When coverage requires maintaining a certain number of hours, those fluctuating schedules can leave workers ineligible — even while actively employed.

For disabled workers, this gap can be even sharper. Some rely on Medicaid because it covers services employer plans often do not — long-term supports, home and community-based services, specialized therapies, or more comprehensive cost protections. Others reduce hours to manage health conditions and lose access to employer coverage as a result.

In those spaces, Medicaid fills in.

The idea that Medicaid is “not for workers” persists because it relies on a simplified picture of work — one where employment automatically equals stability, benefits, and livable wages. But low wages, unpredictable schedules, and limited benefits are not exceptions in the modern economy. They are common features of it.

Caregiving labor complicates this even further. Many people reduce hours or choose lower-paying roles to care for children, aging parents, or family members with disabilities. That labor is essential, but it is not always compensated — and it often affects eligibility for employer coverage.

When we treat Medicaid as separate from work, we erase these realities. We imply that participation in public coverage signals an absence of contribution, rather than an economic mismatch between wages, healthcare costs, and support needs.

The line between “worker” and “Medicaid recipient” is not fixed. It shifts with pay rates, scheduling practices, state policy choices, and the rising cost of care.

Medicaid is not a marker of whether someone works. It is often a reflection of how work — and disability — are structured.