New Medicaid Rule Raises Concerns for Ill Patients Seeking Aid
WHO:
AP News - DeAnna Brandon, a 48-year-old blood cancer survivor from Rockwell, North Carolina.
AP News - Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services (CMS).
AP News - Adrianna McIntyre, a professor at Harvard University’s school of public health.
AP News - Mids Meinberg, a 42-year-old freelance writer from New Jersey living with chronic depression and diabetes.
AP News - Sarah Maresh, healthcare access program director at the advocacy group Nebraska Appleseed.
AP News - Kinda Serafi, a partner at the consulting firm Manatt Health.
WHAT:
AP News - New Medicaid work requirements are set to begin next year.
AP News - The interim final rule released by CMS requires enrollees aged 19 to 64 to show they work or do community service for at least 80 hours a month or are in school at least half the time.
AP News - The new definition of medical frailty requires that a condition must “significantly impair” the ability to work, volunteer, or attend school to qualify for an exemption.
AP News - A $200 million federal allotment is being provided to states to help implement the new policies.
AP News - The additional costs for technology requirements and staffing are expected to exceed $1 billion.
WHERE:
AP News - Rockwell, North Carolina, where DeAnna Brandon resides.
AP News - Jefferson City, Missouri, where Medicaid call center workers are located.
AP News - Nebraska, where one state has started the new Medicaid work requirements ahead of schedule.
WHEN:
AP News - The new Medicaid work requirements are set to begin on January 1, 2027.
AP News - Enrollees will need to prove they meet the new definition of medical frailty when renewing coverage in 2028.
WHY:
AP News - The new rules are intended to eliminate government freeloading and preserve benefits for those who need them most, according to Republicans.
AP News - Critics argue that the new requirements will put more Americans at risk of losing their health insurance.
HOW:
AP News - States are expected to use Medicaid claims data and other sources to automatically exempt eligible enrollees whenever possible.
AP News - CMS has stated that verification through claims data or other documentation will generally be required for renewal in 2028.
(UPDATED June 11, 2026 16:27 UTC)
New Medicaid work requirements are set to begin on January 1, 2027, mandating enrollees aged 19 to 64 to demonstrate at least 80 hours of work or community service each month, or be enrolled in school for at least half the time. The interim final rule from the Centers for Medicare and Medicaid Services also introduces a new definition of medical frailty, requiring that a condition must significantly impair the ability to work, volunteer, or attend school to qualify for an exemption. While a $200 million federal allotment will assist states in implementing these policies, critics warn that the additional costs for technology and staffing could exceed $1 billion, potentially putting more Americans at risk of losing their health insurance.