Waltham, MA, November 3, 2026 — With the Congressional Budget Office projecting that H.R. 1 will cause roughly 11 million people to lose Medicaid coverage by 2034, a new study from the Workers Compensation Research Institute (WCRI) examines the potential implications for workers’ compensation.

“Health insurance coverage can influence workers’ compensation claim frequency and medical spending. Previous WCRI research has documented shifts between group health and workers’ compensation when coverage changes and financial incentives favor workers’ compensation,” said Ramona Tanabe, president and CEO of WCRI.

The potential effects of H.R. 1 extend beyond non-working adults. Approximately two-thirds of non-disabled adult Medicaid beneficiaries were employed in 2023, representing about 16.6 million workers. New work requirements could contribute to coverage losses among working adults who struggle to navigate the reporting and documentation requirements needed to maintain eligibility, even when employed.

The study examines how the 2023–2024 Medicaid unwinding, when states resumed regular eligibility reviews and disenrollments after pandemic-era rules expired, affected workers’ compensation systems. It addresses three key questions:

  • Does Medicaid unwinding affect workers’ compensation claim frequency?
  • Does it affect benefits, including medical payments per claim, indemnity benefits, and the duration of temporary disability?
  • Does it change the use of specific medical services?

To investigate these questions, WCRI researchers analyzed workers’ compensation claims data from national and regional insurers, residual market carriers, state funds, and self-insured employers. The analysis covers injuries occurring between October 2017 and September 2024 across 31 states, representing more than 80 percent of workers’ compensation benefits paid in the United States.

The report, Effect of Losing Medicaid on Workers’ Compensation Benefits, was authored by Johanna Catherine Maclean, Sebastian Negrusa, David Powell, and Vennela Thumula. It is available free to WCRI members and for purchase by nonmembers.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, Massachusetts. WCRI provides objective, high-quality research to help policymakers and other stakeholders make informed decisions about state workers’ compensation systems. Its diverse membership includes employers, insurers, government agencies, managed care companies, health care providers, insurance regulators, labor organizations, and state administrative agencies.