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Work Requirements and Health Care Disparities in Medicaid: A RandomizedControlled Trial

Award Number: R01MD014970
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

Group Awards By Issue Date FY or Funding FY:

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Project Summary/Abstract: Work requirements are becoming increasingly common in major public assistance programs, and starting in 2018, several states have received approval from the federal government to require employment or other qualifying “community engagement activities” to obtain Medicaid coverage. Proponents of work requirements contend that these policies increase beneficiary engagement in work and community activities that may lead to higher incomes and better health. On the other hand, opponents of work requirements suggest that many low-resource households will lose much-needed benefits, without commensurate improvements in employment. More than a dozen states have proposed new Medicaid work requirements in the past year, but there is little rigorous evidence on the effects of these policies in public programs. We propose a randomized controlled trial of work requirements in Virginia, leveraging state support for exempting a portion of Medicaid expansion enrollees from the state's impending work requirements. We will be able to separate the causal impact of enforcing a work requirement from two other new features of Virginia's Medicaid program: additional verification requirements and premiums. Our experimental design will enable us to test for any interactions between work requirements, premiums, and verification requirements. We will study the impacts of each policy on health insurance coverage, access to care, employment, and health outcomes using a mix of administrative data and a new beneficiary survey, and we will oversample several populations of interest, including racial/ethnic minorities and low-income rural residents. In doing so, we will identify the overall policy impacts of these policies, and we will also assess who is most affected by each component to determine the impact of these Medicaid policy changes on racial, ethnic, socioeconomic, and geographic disparities.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $246,067 )
2024	2024	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	25 SHATTUCK ST	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	5	12/9/2023	NON-COMPETING CONTINUATION	$246,067
														Subtotal = $246,067

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	25 SHATTUCK ST	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	4	11/8/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $273,467 )
2022	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	25 SHATTUCK ST	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	001	4	4/29/2022	NON-COMPETING CONTINUATION	$27,347
2022	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	25 SHATTUCK ST	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	4	11/21/2021	NON-COMPETING CONTINUATION	$246,120
														Subtotal = $273,467

Issue Date FY: 2021 ( Subtotal = $622,269 )
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	25 SHATTUCK ST	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	006	3	9/21/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$393,426
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	002	2	5/17/2021	NON-COMPETING CONTINUATION	-$534,931
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	001	2	3/15/2021	NON-COMPETING CONTINUATION	$57,899
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	2	11/23/2020	NON-COMPETING CONTINUATION	$521,079
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	25 SHATTUCK ST	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	003	3	5/17/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$578,222
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	005	2	9/21/2021	NON-COMPETING CONTINUATION	-$44,047
2021	2020	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	004	1	9/21/2021	NEW	-$349,379
														Subtotal = $622,269

Issue Date FY: 2020 ( Subtotal = $558,358 )
2020	2020	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	1	1/7/2020	NEW	$558,358
														Subtotal = $558,358

Grand Total All Awards = $1,700,161

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Work Requirements and Health Care Disparities in Medicaid: A RandomizedControlled Trial

Award Number: R01MD014970

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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