In November 2026, the Workers Compensation Research Institute published a study of how the 2023–24 Medicaid eligibility unwinding affected workers’ compensation claims and medical spending. The study appeared on 3 November and draws on injuries occurring between October 2017 and September 2024 across 31 US states. The public study description establishes the design and research questions. Detailed estimates from the full report have not been independently verified for this article.

Two systems with different obligations

Medicaid covers eligible individuals under public health programmes. Workers’ compensation addresses qualifying work-related injuries under state rules. A worker losing Medicaid does not thereby acquire a compensable claim. Employers should keep the eligibility and causation tests for the two systems distinct, even when both affect whether a worker can access care. A change in the source of payment is also different from a change in the number of injuries.

There are several mechanisms a study can examine. Workers who no longer have another way to pay for care may be more likely to pursue a legitimate claim for a work injury. In other circumstances, delays in getting care could change which services are eventually needed or how long a worker remains off work. Access to clinicians, local rules, the availability of alternative cover and the timing of eligibility decisions may all affect what is observed. These are possible mechanisms, not findings inferred from the study’s headline.

What the research can and cannot tell a buyer

WCRI uses the resumption of regular Medicaid eligibility reviews after pandemic-era rules as the historical setting. Its public description says the data include national and regional insurers, residual market carriers, state funds and self-insured employers. The breadth matters because a single employer may have too few claims to distinguish a genuine pattern from a handful of expensive cases. It does not mean the study can tell every employer how its own costs will change.

Before citing an effect size, examine how the researchers compare groups, which outcomes they measure, how they account for differences among states and how precise the estimates are. Medical spending per claim can move even if claim frequency does not. A change in spending can also reflect a different mix of injuries or services rather than a uniform increase in prices. Results from one episode of eligibility changes should not be used as a forecast for later federal changes without checking who is affected and what alternatives are available.

A useful joint review for benefits and risk teams

The practical step is to compare aggregate information held by benefits, safety and claims teams. Establish baselines for injury reports, accepted claims, the time from injury to first treatment, medical payments and disability duration. Track changes alongside headcount, occupation mix and provider availability. Record when reporting practices change. Individual Medicaid status or clinical information should not be collected for this exercise unless the organisation has a clear purpose and appropriate authority.

For a multinational group, the US example illustrates why a common reporting template should allow for differences in national and local systems. In one country, employment injury and ordinary healthcare costs may be recorded separately; elsewhere, public provision can obscure an apparent transfer between employer-funded programmes. Treat local institutional arrangements as part of the analysis rather than assuming comparable labels imply comparable coverage.

Sources

Workers Compensation Research Institute | WCRI studies how Medicaid coverage losses affect workers’ compensation