American Diabetes Association Disappointed by Centers for Medicare and Medicaid Services Recent Decision to Allow States to Impose Medicaid Work Requirements


Michelle Kirkwood

January 12, 2018

The American Diabetes Association (ADA) is deeply disappointed by the Centers for Medicare and Medicaid Services’ (CMS) decision to allow states to impose work requirements as a condition of Medicaid eligibility. Access to affordable, adequate health coverage is critically important for the more than 114 million Americans living with or at risk for diabetes and anyone with a chronic health condition. When people are not able to afford the care, tools and services necessary to effectively manage their diabetes, they scale back or forego the treatment they need, potentially leading to costly complications and even death.   

Adults with diabetes are disproportionately covered by Medicaid. For low income individuals with diabetes, access to Medicaid coverage is essential to managing their health. Medicaid provides medical assistance to those who cannot afford the costs of medically necessary services. Linking work status to Medicaid eligibility is contrary to its fundamental intent and instead can block access to the health care individuals need to be able to work. According to the Kaiser Family Foundation, most people on Medicaid who can work do so. In addition, the Heritage Foundation and the Center on Budget and Policy Priorities have concluded that rather than encouraging employment, instituting work requirements as a condition of Medicaid eligibility will lead to higher uninsured rates and higher emergency room visits by uninsured individuals who would have been eligible for Medicaid coverage.

A study by the National Bureau of Economic Research concluded Medicaid coverage increases utilization of primary and preventive services, lowers out-of-pocket medical spending and medical debt, and results in better self-reported physical and mental health. In addition, Medicaid enrollees are 15 percent more likely to be screened for diabetes than someone who is uninsured. Centers for Disease Control and Prevention (CDC) diabetes data shows prevention programs and early detection can prevent the onset of type 2 diabetes and reduce state spending. 

The ADA remains committed to working with CMS and state Medicaid departments to ensure everyone with and at risk for diabetes has access to high quality, affordable health care, regardless of income and employment status.

About the American Diabetes Association

Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation’s leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn)