Medicaid work requirement exemptions
Over the last year, federal health officials stated that certain people and groups would be exempt from these requirements, including women who are pregnant or have recently given birth, people with disabilities or medical conditions, parents and caretakers of children age 13 and younger or people with disabilities, those in treatment for alcohol or drug addiction, American Indians, Alaska Natives, and others.
The Centers for Medicare & Medicaid Services released interim guidance on June 1 about how states should process medical frailty exemptions and under what circumstances.
The definition stipulates that in addition to having a qualifying condition, people must prove that their medical frailty will “significantly impair their ability to comply with the [work] requirement,” the federal agency stated.
People will be able to self-attest their condition under the frailty definition throughout 2027 and once in 2028, but will then need to provide proof. Otherwise, they risk losing Medicaid health insurance.
Democrats in the lawsuit argue that the work requirements and exemption rules are unconstitutional and violate federal administrative procedural law.
“People with disabilities, patients in the middle of cancer treatment, or those struggling with another serious or complex health condition, shouldn’t be at risk of losing the care that helps maintain their health,” plaintiffs wrote in court documents. “Nowhere in H.R. 1 does Congress state that individuals’ ability to work must be impaired in order to be ‘medically frail or otherwise have special medical needs,’ or to have a ‘serious or complex medical condition.’”
Pennsylvania Gov. Josh Shapiro blamed the president, Dr. Mehmet Oz, the head of the Centers for Medicare & Medicaid Services, and Health Secretary Robert F. Kennedy Jr. “for trying to rip away Medicaid from Pennsylvanians who need it most.”
“Donald Trump, Dr. Oz, and RFK Jr. are hellbent on trying to push aside people who rely on Medicaid to get the care they need,” Shapiro said in a statement on social media. “But here in Pennsylvania, we’re going to keep standing up to protect our most vulnerable Pennsylvanians.”
