New Medicaid work requirements ‘not a realistic and successful strategy’

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Medicaid leaders and advocates say they’re shocked by the Trump administration’s harsh directives for implementing Medicaid work requirements, which they say mark a pivot from how federal officials had characterized their plans just weeks ago. 

Much of the conversation around the nearly 400-page rule that the Centers for Medicare and Medicaid Services released Monday afternoon centers on one of the ways that people can be exempted from work requirements: medical frailty. Getting that exemption will be more difficult than most people had expected, meaning that more sick and disabled people are likely to lose their Medicaid coverage. 

“This is where we’ll see large and harmful coverage losses,” said Benjamin Sommers, an economics professor at the Harvard T. H. Chan School of Public Health. “This is a population that has high medical needs and is at major risk for harm if they lose coverage. That is the headline implication of the new rule.”