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As I and many others have been warning about for the past year or so, the upcoming so-called "work requirements" (aka "paperwork hell" requirements) of last year's Big Ugly Bill are ramping up in January...and in fact have already begun in Nebraska. A few days ago the Centers for Medicare & Medicaid Services (CMS) published their "final rule" with the reporting and exemption regulations which every state which has expanded Medicaid under the Affordable Care Act will be required to follow...and, as expected, it's likely to be a disaster.
Advocates for people with serious illnesses, like cancer and HIV, say the strict Medicaid work rules that the Trump administration released this week are likely to put ongoing treatments in jeopardy.
...States must "make the changes, test the changes to make sure they're not going to break the system, and then go live," McIntyre says.
The nearly 400-page interim final rule released Monday makes that process even harder. For months, federal officials have been meeting with states informally and giving them guidance, and states understood that people with conditions where continuous health insurance coverage was really important would be exempt.
"What the rule says, as published, is that that's actually not enough," McIntyre explains. "The condition or the disease needs to be actively interfering with your ability to work. So people with early stage cancer who are in radiation treatment but still have the capacity to work, or people who have HIV but can still technically work, are not exempted from the work requirement."
McIntyre and others foresee situations where a person newly diagnosed with cancer, who is working, loses Medicaid because they don't fill out the paperwork correctly. That could lead to patients losing coverage when they need it most.
There were around 20.4 million Americans enrolled in Medicaid via ACA expansion as of a year ago. It's likely dropped a bit since then but should still be over the 20 million threshold.
I refuse to call the new rules "work requirements" because the vast majority of adults on Medicaid already work. Via a KFF analysis from last year, 54% of the Medicaid expansion population (adults 19 - 64 who don't otherwise receive disability payments, aren't enrolled in Medicare, etc) work at least 80 hours per month (the minimum requirement under the new rules); another 9% are enrolled in school full time; 15% are sick or disabled (ie, the conditions which are kind of the reason why having Medicaid coverage is so important to begin with); and 2% are caregivers for sick/disabled relatives.
https://acasignups.net/26/06/04/big-ugly-bills-dance-spider-dance-mandate-set-kick-cancer-hiv-patients-medicaid
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I keep hearing the GOP isn't cruel but they're trying to kick cancer patients off of Medicaid