A coalition of physician groups, individual Medicaid enrollees and the city of Columbus are joining forces to sue the feds over regulations governing the rollout of work requirements at the beginning of next year.
The rule, issued on June 1, outlines exemptions and other eligibility details for the program. Under H.R.1, or the One Big Beautiful Bill Act, able-bodied and non-pregnant adults between ages 19 and 64 will have to complete at least 80 hours per month of work, community service or job training to maintain their benefits.
The eligibility requirements were more stringent than the industry expected, and multiple organizations have warned that it would make it quite difficult for individuals who qualify for exemptions to maintain their coverage.
In the lawsuit, the groups note that the rule narrowly defined who qualifies for exemptions based on medical frailty, which they argue puts vulnerable patients at greater risk of losing their Medicaid coverage.
The medical groups joining the suit include the American College of Physicians, American Academy of Pediatrics, Society for Adolescent Health and Medicine, Doctors for America, New Hampshire Medical Society and the New Hampshire Chapter of the American Academy of Pediatrics, all of which treat vulnerable patients.
“When adults lose health care coverage, children are more likely to lose coverage, and we know even short disruptions in children’s coverage can have serious consequences for their overall health, from missed appointments to unfilled prescriptions to trips to the emergency department,” said Andrew Racine, M.D., president of the American Academy of Pediatrics, in a press release. “This new rule needlessly puts the health of families and children at risk."
"Our federal leaders should be advancing policies that make accessing health care as seamless and efficient as possible for families – this rule does the opposite," Racine continued.
The lawsuit alleges that the tight requirements could impacting individuals with diabetes, cancer, HIV, substance use disorders, disabling mental health conditions and other serious or complex medical conditions. Losing coverage could lead to worse health, making it harder for these patients to maintain work.
Multiple studies and industry experts have shown that many people who are enrolled in Medicaid are already working.
The lawsuit is supported by legal council from the National Health Law Program and Democracy Forward.
“Every additional verification requirement, form, and submission creates another opportunity for an error or misunderstanding to cost someone their coverage," said Jennifer Cannistra, Executive Director of the National Health Law Program, in the announcement. "Past experience shows that many of the people who lose Medicaid are already working or qualify for an exclusion. They lose coverage because of paperwork and administrative barriers, not because they are ineligible."