Waiver of Medicaid Work Requirements
Last year, federal health officials indicated that certain individuals and groups are excluded from Medicaid work requirements. This includes pregnant women, new mothers, people with disabilities or medical conditions, parents or caregivers of children under 13, individuals seeking treatment for substance abuse, as well as American Indians and Alaska Natives.
The Centers for Medicare and Medicaid Services issued interim guidance on June 1, prompting states to discuss how to approach medical frailty exemptions.
The guidance explains that, in addition to having a qualifying condition, individuals must show that their medical issues “significantly impair their ability to comply with the work requirements,” according to the federal agency.
Individuals can self-certify their medical frailty status until 2027, but after that, they will need to provide supporting evidence. Failing to do so may jeopardize their Medicaid coverage.
Democrats involved in the lawsuit assert that the work requirements and exemption criteria are unconstitutional and breach the federal Administrative Procedure Act.
“No one facing disability, undergoing cancer treatment, or dealing with another serious health issue should risk losing the essential care that supports their well-being,” the plaintiffs stated in court documents. They highlighted that “nowhere in H.R. 1 does Congress specify that a person’s ability to work must be impaired to be deemed ‘medically frail or have special medical needs,’ or categorized as having a ‘serious or complex medical condition.’
Pennsylvania Governor Josh Shapiro has accused the president, Centers for Medicare and Medicaid Services Director Dr. Mehmet Oz, and Secretary of Health Robert F. Kennedy Jr. of attempting to strip Medicaid from those in Pennsylvania who need it most.
Shapiro expressed in a social media statement, “Donald Trump, Dr. Oz, RFK Jr., and others are determined to eliminate support for those relying on Medicaid for necessary care. But here in Pennsylvania, we will continue to advocate for our most vulnerable residents.”
