US President Donald Trump signed the Federal Budget Reconciliation Bill, also known as the 'One Big, Beautiful Bill Act,' into law last July. The legislation imposed new work requirements for Medicaid recipients in the 40 Medicaid expansion states plus Washington D.C.
Medicaid recipients in the 40 Medicaid expansion states and Washington D.C. must work, volunteer, or undergo job training for 80 hours every month to maintain benefits. The new requirements are set to begin on January 1, 2027, according to some reports, though other reports suggest they could go into effect as early as this coming January.
The Trump administration issued guidance on the Medicaid work requirements last month. Exemptions are granted to pregnant women, individuals with a documented disability, and parents or guardians of a disabled child under age 14. Individuals classified as 'medically frail' may also be exempt.
Medicaid expansion states may allow individuals to self-attest that they are unable to meet work requirements through 2027. Some states, such as Nebraska, are rolling out Medicaid work requirements as early as next week.
The National Organization for Rare Disorders (NORD) submitted a public comment on the new Medicaid work requirements on Wednesday. NORD CEO Pamela Gavin stated, 'There are challenges to really understanding what is going on until it happens.'
Average Medicaid spend for disabled individuals.
A federal judge on Thursday denied a request by more than two dozen Democratic states to halt the Trump administration's Medicaid work requirement policy, without ruling on the merits of the lawsuit. The Centers for Medicare and Medicaid Services (CMS) introduced a rule stating that a terminal diagnosis (e.g., cancer, HIV/AIDS, or Parkinson's) is not sufficient for a Medicaid work requirement exemption.
Beginning January 1, 2028, individuals with terminal diseases must demonstrate that their condition 'significantly impairs' their ability to meet work requirements. Democratic attorneys general from 25 states and the District of Columbia filed a preliminary injunction against the CMS rule.
You are talking about a lot more paperwork, more evaluations, more doctor visits...
The American Medical Association, the American College of Physicians, and the American Academy of Pediatrics have opposed the new Medicaid rule. Lisa Lacasse, president of the American Cancer Society Cancer Action Network, stated, 'The new restrictions link the definition of medical frailty to a person’s ability to work.'
The US Congressional Budget Office (CBO) projects that Republican healthcare policy changes could increase the number of uninsured Americans by approximately 11.8 million over the next decade. Of that increase, approximately 5.7 million are expected to be Medicaid recipients who fail to meet work requirements or encounter paperwork hurdles.
In Arizona, US, 440,000 people have been dropped from the Supplemental Nutrition Assistance Program (SNAP) following new paperwork requirements. Additionally, over 4 in 10 cancer patients over age 50 have depleted all their assets within two years of diagnosis.
