With the Congressional Budget Office projecting that H.R. 1 will result in approximately 11 million people losing Medicaid coverage by 2034, this study examines how changes in Medicaid eligibility may affect workers’ compensation claim frequency and medical spending.

Previous WCRI research has documented shifts between group health and workers’ compensation when health insurance coverage changes, particularly when financial incentives favor workers’ compensation.

The potential effects of H.R. 1 extend to working adults. In 2023, approximately two-thirds of non-disabled adult Medicaid beneficiaries were employed, representing about 16.6 million workers. New work requirements could lead to coverage losses among employed adults who struggle to meet reporting and documentation requirements, even when they remain eligible.

To better understand these potential effects, the study examines how the 2023–2024 Medicaid unwinding—when states resumed regular eligibility reviews and disenrollments following the expiration of pandemic-era rules—affected workers’ compensation systems.

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.

Effect of Losing Medicaid on Workers' Compensation Benefits. Johanna Catherine Maclean, Sebastian Negrusa, David Powell, and Vennela Thumula. November 2026. WC-26-22.

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