{"id":1973,"date":"2026-06-06T16:06:40","date_gmt":"2026-06-06T16:06:40","guid":{"rendered":"https:\/\/relocationtimess.com\/?p=1973"},"modified":"2026-06-06T16:06:40","modified_gmt":"2026-06-06T16:06:40","slug":"the-trump-administration-makes-it-harder-for-some-sick-americans-to-maintain-medicaid","status":"publish","type":"post","link":"https:\/\/relocationtimess.com\/?p=1973","title":{"rendered":"The Trump administration makes it harder for some sick Americans to maintain Medicaid"},"content":{"rendered":"<div>\n<div>\n<div>\n<div>\n<button><br \/>\n<strong><br \/>\n<span><svg>\n<\/svg><br \/>\n<\/span><br \/>\n<span>Summary<\/span><br \/>\n<\/strong><br \/>\n<span><svg><\/svg><br \/>\n<\/span><br \/>\n<span><svg><\/svg><br \/>\n<\/span><br \/>\n<\/button><\/p>\n<div>\n<ul>\n<li>A new federal rule makes it more difficult for sick Medicaid enrollees to qualify for an exemption from work requirements, which start in January in most states.<\/li>\n<li>To qualify for the medical frailty exemption, enrollees&#8217; health condition must significantly impairs their ability to work.<\/li>\n<li>Patient advocacy groups warn the stricter standard could result in enrollees with serious medical conditions losing coverage.<\/li>\n<\/ul>\n<div>\n<span>AI-generated summary was reviewed by a CNN editor.<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>\n            Millions of sick Americans could have a tougher time retaining \u2014 or even signing up for \u2014 Medicaid coverage after the first-ever federal work requirement begins in January in most states.\n    <\/p>\n<p>Read more <a href=\"https:\/\/relocationtimess.com\/?p=1971\">Sick of snoring? We asked doctors for the best anti-snoring products<\/a><\/p>\n<p>\n            That\u2019s because the Centers for Medicare and Medicaid Services issued a new rule this week thattakes a harder line on defining which low-income adult enrollees are eligible for an exemption for those who are\u201cmedically frail.\u201d The rule guides states on implementing the work mandate.\n    <\/p>\n<p>\n            To qualify for the exemption, not only must enrollees have an illness or medical condition, such as cancer or a behavioral health issue, but that condition must also significantly impair their ability to comply with the work mandate, according to the rule, released Monday.\n    <\/p>\n<p>\n            The interpretation came as a surprise to many states and patient advocacy groups and immediately sparked an outcry, with warnings that it will strip needed health coverage from sick enrollees covered through Medicaid expansion.\n    <\/p>\n<p>\n            \u201cIt is going to impose a lot more burdens to keeping coverage on people who have very serious conditions for whom loss of coverage can be catastrophic,\u201d said Jocelyn Guyer, senior managing director at Manatt Health, a legal and consulting firm that advises states on Medicaid policy. \u201cIt will increase the number of people who lose coverage.\u201d\n    <\/p>\n<p>\n            The work mandate was included in President Donald Trump and his party\u2019s One Big Beautiful Bill Act, which passed last year. CMS is in the process of issuing rules to help states implement the health provisions in the law, which includes historic cuts to Medicaid. The agency said its key focus for work requirements is to increase Medicaid enrollees\u2019 self-sufficiency and economic mobility, while protecting the vulnerable.\n    <\/p>\n<p>\n            The OBBBA  requires Medicaid expansion enrollees ages 19 through 64 to work, volunteer, attend school or participate in a job program at least 80 hours a month, unless they are eligible for certain exemptions. Some 5.3 million more people are expected to be uninsured in 2034 because of the work requirement, according to a Congressional Budget Office estimate from last summer.\n    <\/p>\n<p>\n            Tying the exemption to an enrollee\u2019s inability to work, however, is not in the law itself, experts told CNN.\n    <\/p>\n<h2>\n        Concerns about care<br \/>\n<\/h2>\n<p>\n            The rule prompted a swift response from a multitude of patient advocacy groups, who say the stricter interpretation will put people\u2019s lives at risk by jeopardizing their coverage and access to care.\n    <\/p>\n<p>\n            \u201cBecause of these requirements, an individual fighting for their life in active cancer treatment will now also have to have to climb what, for some, will be insurmountable obstacles to get or maintain coverage,\u201d  said Jennifer Hoque, associate policy principal at the American Cancer Society Cancer Action Network. \u201cIf they aren\u2019t able to get through the system fast enough, they\u2019ll show up to chemo or show up for cancer surgery and find out they don\u2019t have the coverage they need. Their lifesaving treatment will be taken from them.\u201d\n    <\/p>\n<p>\n            CMS\u2019 interpretation \u201cclearly conflicts\u201d with the One Big Beautiful Bill Act, according to a group of 48 patient organizations, including the American Lung Association, the Crohn\u2019s &amp; Colitis Foundation, and the National Alliance on Mental Illness.\n    <\/p>\n<p>\n            \u201cRedefining the law\u2019s medical frailty exemption to only apply to individuals who can prove they cannot work and drastically limiting the ability of states to accept self-attestation from patients about compliance and exemptions starting in 2028 clearly conflicts with the law,\u201d the group said in a statement.\n    <\/p>\n<p>\n            \u201cThese policies will place massive paperwork burdens on patients and providers, upend months of planning by states and create chaos just months away from the January 2027 implementation deadline.\u201d\n    <\/p>\n<p>\n            CMS did not reply to a request for comment about advocates\u2019 concerns.\n    <\/p>\n<h2>\n        Scramble for states<br \/>\n<\/h2>\n<p>\n            The surprise interpretation adds an extra, two-step hurdle for state Medicaid agencies, who are already facing tight deadlines to stand up their work requirement programs by January. Many have already been setting up their systems based on informal guidance from CMS and must now make changes. Meanwhile, Nebraska launched its work mandate last month but will now have to conform to the new rule.\n    <\/p>\n<p>\n            What\u2019s more, CMS did not provide guidance to states on how to define and assess whether a person meets the medically frail exemption criteria, said Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at KFF, a nonpartisan health policy organization. States will likely adopt different practices, meaning there won\u2019t be a uniform standard for determining if someone is too sick to work.\n    <\/p>\n<p>Read more <a href=\"https:\/\/relocationtimess.com\/?p=1929\">Vulnerable Republicans increasingly willing to defy Trump\u2019s agenda as midterms approach<\/a><\/p>\n<p>\n            Further complicating matters is that the severity of these enrollees\u2019 medical conditions \u2014 and the impact on their ability to work \u2014 can vary over time, as the rule noted.\n    <\/p>\n<p>\n            The provision could also put doctors in a tough spot, since they may be called upon to help determine whether someone is able to work, which would affect their patient\u2019s coverage. That is not typically part of providers\u2019 clinical practice and area of expertise, Guyer said.\n    <\/p>\n<p>\n            Plus, starting in 2028, enrollees and those signing up for Medicaid will only be allowed to self-attest that they qualify for the medical frailty exemption once. After that, if states don\u2019t have data on file to confirm people\u2019s eligibility, enrollees may have to provide documentation, which could prove to be a big lift for some.\n    <\/p>\n<p>\n            States also will not be able to add additional categories to the exemption. For instance, the rule notes that being homeless would not automatically qualify a person as medically frail since that circumstance is not a health condition. However, if that person had a substance use disorder or mental health condition, they could be eligible for the exemption.\n    <\/p>\n<h2>\n        Curbing fraud<br \/>\n<\/h2>\n<p>\n            CMS officials defended their interpretation of the law in a call with reporters, which largely focused on the medical frailty provisions. States can use health claims data or ask for other documentation to determine whether an enrollee meets the criteria in the rule, they said.\n    <\/p>\n<p>\n            \u201cThe exemption ensures that work expectations are directed towards those who can participate, while protecting those who cannot,\u201d said Dan Brillman, who directs CMS\u2019 Medicaid program.\n    <\/p>\n<p>\n            Dr. Mehmet Oz, who oversees CMS and is a key player in the Trump administration\u2019s crackdown on fraud in federal programs, linked the provisions to maintaining the program integrity.\n    <\/p>\n<p>\n            \u201cThe mantra that we kept coming back to was that we\u2019re forgiving but we\u2019re not foolish,\u201d Oz told reporters, noting that the work mandate will preserve Medicaid for the vulnerable. \u201cDirectionally, we are appropriately going after problem areas and doing it in a way that\u2019s compassionate, forgiving \u2014 but we don\u2019t want to be fools.\u201d\n    <\/p>\n<p>\n            The medically frail exemption is one of several examples of CMS\u2019 stricter interpretations of the Big Beautiful Bill. Starting in 2028, the agency is eliminating the ability for enrollees to self-attest that they are meeting the work requirement, which can be important for gig workers or the self-employed, or that they qualify for an exemption, such as serving as a caregiver.\n    <\/p>\n<p>\n            In 2027, states can accept self-attestations when there is no reliable data available to prove work hours or exemption eligibility.\n    <\/p>\n<p>\n            Oz warned that enrollees must be honest when self-attesting.\n    <\/p>\n<p>\n            \u201cIn the rare instance where you\u2019re self-attesting, you need to tell the truth,\u201d he told reporters on Monday. \u201cWe will be speaking with the different enforcement bodies to make sure that folks know that\u2019s not a joke.\u201d\n    <\/p>\n<p>\n            Also, CMS last month proposed a rule that would further curtail states\u2019 ability to boost certain types of payments to providers \u2014 beyond the limits Congress included in the law. These payments are used to encourage provider participation and improve access to care for Medicaid enrollees, but the agency argues that the practice drives up costs without ensuring better health outcomes.\n    <\/p>\n<p>\n            The stricter work requirement rule met with the approval of at least one conservative health policy expert. Brian Blase, the president of Paragon Health Institute and an influential voice with the White House and Republican lawmakers, said it \u201cstrikes the appropriate balance\u201d between protecting Medicaid\u2019s integrity and accommodating those in need.\n    <\/p>\n<p>\n            \u201cSelf-attestation alone for compliance or exemptions \u2014 particularly for medical frailty \u2014 risks repeating the improper enrollment and fraud seen in other programs when verification standards were weakened,\u201d he said in a statement.\n    <\/p>\n<p>Read more <a href=\"https:\/\/relocationtimess.com\/?p=1923\">A total solar eclipse will occur this summer. Everything you need to know<\/a><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Millions of sick Americans could have a tougher time retaining \u2013 or even signing up for \u2013 Medicaid coverage after the first-ever federal work requirement begins in January.<\/p>\n","protected":false},"author":1,"featured_media":1972,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1973","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-politics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Trump administration makes it harder for some sick Americans to maintain Medicaid - Relocation Times<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/relocationtimess.com\/?p=1973\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Trump administration makes it harder for some sick Americans to maintain Medicaid - 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