Miranda Yaver breaks down CMS’s new Medicaid community engagement rule, work requirements for people with disabilities, medical frailty exclusions, and what it all really means.

Please join us for our July General Assembly, focused on the harms coming from proposed rules related to Medicaid work requirements.

The Centers for Medicare and Medicaid Services proposed its rule to carry out the Medicaid work requirements of HR1, the “One Big Beautiful Bill Act,” but in doing so, it set out a policy even more restrictive than what Congress required. Congress’s imposition of Medicaid work requirements is already a solution in search of a problem given that most Medicaid enrollees are working or would fall into an exemption category. But one of the challenges is determining who exactly falls within these exempt categories, and who will remain subject to the documentation burdens or risk losing coverage. By defining “medical frailty” as constituting health conditions that prevent one from doing any sort of work, as opposed to a serious or complex medical condition (as Congress had required), the Administration’s proposed rule is putting people with a wide range of illness at risk of losing their health coverage — and, in turn, necessary medical care — when their ability to work varies over time. This will lead to greater barriers to treating both chronic and infectious diseases, and place greater strain on health systems.

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