NCT04888832

Brief Summary

More than a dozen states have proposed or plan to implement work requirements in Medicaid, and similar requirements already exist nationally in the Supplemental Nutritional Assistance Program (SNAP), yet evidence on the effects of these policies is limited. In cooperation with the state of Virginia, the investigators plan to conduct a randomized controlled trial studying the impacts of work requirements in public programs on insurance coverage, SNAP participation, employment, and health, with a particular focus on changes in racial/ethnic and geographic disparities in these outcomes. The COVID-19 epidemic and concurrent economic downturn creates additional urgency around these issues, and the investigators will use a combination of national administrative data and a new population survey to assess disparities in employment, health care, and food insecurity during this crisis.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
12,500

participants targeted

Target at P75+ for not_applicable

Timeline
6mo left

Started Apr 2024

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress79%
Apr 2024Dec 2026

First Submitted

Initial submission to the registry

May 7, 2021

Completed
10 days until next milestone

First Posted

Study publicly available on registry

May 17, 2021

Completed
2.9 years until next milestone

Study Start

First participant enrolled

April 1, 2024

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2025

Completed
1.6 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2026

Expected
Last Updated

March 5, 2025

Status Verified

February 1, 2025

Enrollment Period

1.1 years

First QC Date

May 7, 2021

Last Update Submit

February 28, 2025

Conditions

Health DisparitiesFood Security

Keywords

Supplemental Nutrition Assistance Programwork requirementsMedicaid

Outcome Measures

Primary Outcomes (4)

  • SNAP enrollment

    Collected administratively (DSS records)

    Up to 24 months after randomization

  • Employment status

    Collected administratively (VEC records)

    Up to 24 months after randomization

  • UI covered earnings

    Collected administratively (VEC records)

    Up to 24 months after randomization

  • Non-UI covered earnings

    Collected administratively (federal tax records)

    Up to 24 months after randomization

Secondary Outcomes (16)

  • Number of jobs held

    Up to 24 months after randomization

  • Medicaid participation

    Up to 24 months after randomization

  • Hospitalizations

    Up to 24 months after randomization

  • Credit scores

    Up to 24 months after randomization

  • Evictions

    Up to 24 months after randomization

  • +11 more secondary outcomes

Study Arms (5)

Control Group

NO INTERVENTION

No change to work requirements or recertification period

Intervention Group 1

ACTIVE COMPARATOR

Standard 6-month recertification period, additional 6-month work requirement exemption

Other: Work requirement exemption months

Intervention Group 2

ACTIVE COMPARATOR

Standard 6-month recertification period, additional 12-month work requirement exemption

Other: Work requirement exemption months

Intervention Group 3

ACTIVE COMPARATOR

Standard 6-month recertification period, additional 12-month work requirement exemption

Other: Work requirement exemption months

Intervention Group 4

ACTIVE COMPARATOR

12-month recertification period (6-month extension), additional 6-month work requirement exemption

Other: Work requirement exemption months

Interventions

Work requirement exemption monthsOTHER

Cross-randomized intervention will test effect of additional exemption months before work requirements in SNAP become binding and extensions of the standard SNAP recertification period.

Also known as: Change to recertification timeline
Intervention Group 1Intervention Group 2Intervention Group 3Intervention Group 4

Eligibility Criteria

Age18 Years - 49 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Eligible for Virginia's SNAP program as an "able-bodied adult without dependents" (ABAWD) and thus subject to work requirements (this eligibility is age restricted to 18-49)

You may not qualify if:

  • Categorical exemption from work requirements for any reason (e.g., has a disability, has dependents, resides in a geographic area where work requirements have been waived due to elevated employment)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Virginia Department of Social Services (Home Office)

Glen Allen, Virginia, 23060, United States

RECRUITING

Central Study Contacts

Timothy J Layton, PhD

CONTACT

573-353-1566Layton@hcp.med.harvard.edu

Adrianna McIntyre, PhD

CONTACT

5863068889amcintyre@g.harvard.edu

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
30th Anniversary Associate Professor of Health Care Policy

Study Record Dates

First Submitted

May 7, 2021

First Posted

May 17, 2021

Study Start

April 1, 2024

Primary Completion

May 1, 2025

Study Completion (Estimated)

December 1, 2026

Last Updated

March 5, 2025

Record last verified: 2025-02

Data Sharing

IPD Sharing
Will not share

Locations

US(1)