{"id":36864,"date":"2026-06-04T22:17:31","date_gmt":"2026-06-04T22:17:31","guid":{"rendered":"https:\/\/www.europesays.com\/news\/36864\/"},"modified":"2026-06-04T22:17:31","modified_gmt":"2026-06-04T22:17:31","slug":"new-medicaid-work-requirements-are-catastrophic-for-cancer-patients","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/news\/36864\/","title":{"rendered":"New Medicaid work requirements are catastrophic for cancer patients"},"content":{"rendered":"

In May 2025, I\u00a0joined\u00a0more than 160 blood cancer advocates on Capitol Hill.\u00a0At the time, Congress was considering changes to Medicaid, a state and federal program that is a lifeline for more than\u00a075 million Americans<\/a>, including older adults, children, veterans, people with disabilities, pregnant people, and adults with low incomes. Together, we advocated against policies that threatened to put health care out of reach for millions.\u00a0\u00a0<\/p>\n

One of those\u00a0concerning\u00a0policies was work reporting requirements for people covered by Medicaid. The then-proposed legislation\u00a0mandated\u00a0that states verify\u00a0Medicaid\u00a0enrollees\u2019 monthly work status at least every six months to\u00a0ensure\u00a0that they are engaging\u00a0each month\u00a0in a\u00a0minimum of\u00a080 hours\u00a0of community service, educational\u00a0activities,\u00a0and\/or work.\u00a0But undergoing cancer treatment is already a full-time job; many patients\u00a0are unable to work because of their condition.\u00a0\u00a0<\/p>\n

Our meetings with\u00a0congressional staff and lawmakers were tense.\u00a0Many lawmakers were surprised to hear our concerns, given that the legislation they were considering included an exemption for people with serious conditions like cancer.\u00a0When we\u00a0shared that exemptions previously\u00a0failed to\u00a0protect patients,\u00a0many\u00a0lawmakers\u00a0told us we were misinformed or\u00a0being lied\u00a0to. Lawmakers were\u00a0clear<\/a>\u00a0that the legislation\u2019s protections were rock solid: No one with cancer would lose their coverage.\u00a0\u00a0<\/p>\n

A\u00a0few\u00a0weeks later,\u00a0the One Big Beautiful Bill Act (OBBBA) \u2014 and Medicaid work reporting requirements \u2014 became law<\/a>.\u00a0On Monday, the Centers for Medicare and Medicaid Services\u00a0issued its interim final rule\u00a0on work reporting requirements<\/a>. It breaks\u00a0lawmakers\u2019 promises\u00a0to patients.\u00a0<\/p>\n

The rule is catastrophic for cancer patients\u00a0and\u00a0forces\u00a0states to\u00a0go\u00a0far beyond what\u00a0Congress included in\u00a0its legislative text. It narrows the \u201cmedical frailty exemption,\u201d a mechanism that allows patients with cancer and other serious health conditions to be exempt from work reporting requirements. In effect, it means that cancer patients,\u00a0including those\u00a0in active treatment,\u00a0could\u00a0be forced to\u00a0work\u00a0the same number of hours as a healthy person \u2014 regardless\u00a0of whether that\u2019s\u00a0physically\u00a0possible,\u00a0just to keep the health insurance coverage that they rely on to stay alive.\u00a0\u00a0<\/p>\n

\t\t\t\"\"\t\t<\/p>\n

\t\t\t\t\"\"\/
\n\t\t\t\tSTAT Plus: Trump\u2019s Medicaid work requirements have an unwelcome surprise for some states and patients<\/a><\/p>\n

In other words, one of\u00a0the cancer\u00a0community\u2019s worst fears \u2014 which we\u00a0were\u00a0assured\u00a0repeatedly\u00a0would never\u00a0happen\u00a0\u2014\u00a0is\u00a0coming to pass.\u00a0\u00a0<\/p>\n

The rule also\u00a0limits\u00a0patients\u2019 ability to\u00a0attest\u00a0that they qualify\u00a0for\u00a0their\u00a0exemption.\u00a0I\u00a0don\u2019t\u00a0know a single cancer patient who would choose not to work if they could.\u00a0But rather than trusting patients to certify that they have a health condition that precludes them from work reporting requirements, starting nationwide in 2028, patients now face red tape. We don\u2019t know exactly how states will require patients to \u201cprove\u201d their inability to work 20 hours a week, but it seems likely that some patients will need to work with their doctors to submit a written assessment\u00a0of their ability to work\u00a0to Medicaid to prevent loss of their insurance.\u00a0<\/p>\n

As a result, patients will\u00a0be\u00a0inundated with paperwork. One\u00a0small\u00a0misstep\u00a0by a patient, provider, contractor, or state employee\u00a0could mean the difference between having health coverage and losing it.\u00a0Research\u00a0shows\u00a0that\u00a0continuous access to Medicaid is critical<\/a> to\u00a0the survival of children and young adults with cancer.\u00a0\u00a0<\/p>\n

The interim final rule is in direct conflict with OBBBA.\u00a0While Congress chose to implement these work reporting requirements, it also\u00a0carefully\u00a0chose to exempt people with serious medical needs, like cancer patients, from them.\u00a0\u00a0<\/p>\n

In fact, just weeks before the final bill passed,\u00a0Brett Guthrie, chair of the House Energy and Commerce Committee, wrote in the\u00a0New York Post<\/a>: \u201cThis policy applies only to able-bodied, unemployed adults who have chosen not to work. Our bill\u00a0couldn\u2019t\u00a0be clearer about that; it includes\u00a0a long list\u00a0of exempted individuals. For instance \u2026\u00a0you\u2019re\u00a0exempt if\u00a0you\u2019re\u00a0medically frail, which includes anyone\u00a0who\u2019s\u00a0blind, disabled, battling a chronic substance-use disorder or living with a serious and complex medical condition like cancer.\u201d\u00a0<\/p>\n

\t\t\t\"\"\t\t<\/p>\n

\t\t\t\t\"\"\/
\n\t\t\t\tSTAT Plus: Trump administration releases rules for new Medicaid work requirements<\/a><\/p>\n

But\u00a0that\u2019s\u00a0not what the new interim rule\u00a0does.\u00a0Instead of ensuring those who need\u00a0care\u00a0the most can get it as Congress prescribed,\u00a0it\u00a0erects barriers, jeopardizing\u00a0patients\u2019\u00a0ability to focus on what matters most: their health.\u00a0\u00a0<\/p>\n

Since the rule\u00a0doesn\u2019t\u00a0take effect until July 31, 2026, there\u2019s still time for the administration to correct it \u2014 and for\u00a0Congress to ensure that their promises of exemptions were not hollow. I urge them to take\u00a0that opportunity.\u00a0\u00a0<\/p>\n

Why? Because the final interim rule\u00a0just\u00a0does not\u00a0work.\u00a0If left in place,\u00a0it\u00a0will cause irrevocable harm \u2014 not just for cancer patients, but for\u00a0anyone living\u00a0with or caring for someone with a\u00a0serious\u00a0or\u00a0chronic condition.\u00a0And for some, it will be deadly.\u00a0<\/p>\n

We know this because\u00a0we\u2019ve\u00a0already seen it. Both Arkansas<\/a> and Georgia<\/a> implemented Medicaid work requirements during the first Trump administration,\u00a0and they serve as cautionary tales.\u00a0In Arkansas, implementation of work requirements led to significant coverage losses and no increase in employment. Georgia saw small coverage gains \u2014 but at a prohibitively expensive operating cost.<\/p>\n

Even before the new rule, patients have struggled to get the care they are entitled to.<\/p>\n

Brian Becker<\/a>, a 32-year-old father and leukemia patient from Texas,\u00a0died\u00a0while he was\u00a0waiting\u00a0to qualify\u00a0for Medicaid coverage.\u00a0While\u00a0his family\u00a0was mourning his death,\u00a0they received\u00a0a denial letter\u00a0stating\u00a0he\u00a0didn\u2019t\u00a0qualify for disability.\u00a0\u00a0<\/p>\n

His tragedy\u00a0isn\u2019t\u00a0unique, and if\u00a0CMS\u00a0doesn\u2019t\u00a0change course, stories like these will be even more common.\u00a0That\u2019s\u00a0not the reality I want for\u00a0patients, who\u00a0are already undergoing significant physical,\u00a0emotional,\u00a0and financial challenges.\u00a0\u00a0<\/p>\n

For instance, take\u00a0Amanda Brunson, a Florida-based volunteer with Blood Cancer United. Amanda was diagnosed with acute lymphoblastic leukemia at 21 years old and again at 25. She credits Medicaid for saving her life; without it, she would not have been able to afford treatment, medications, food,\u00a0or stable housing.\u00a0\u00a0<\/p>\n

\t\t\t\"\"\t\t<\/p>\n

\t\t\t\t\"\"\/
\n\t\t\t\tSTAT Plus: A giant question looms over GOP\u2019s new Medicaid work requirements<\/a><\/p>\n

Amanda\u2019s journey was grueling. She recalls being severely fatigued, passing out trying to bathe herself, and losing so much weight\u00a0that\u00a0she was a mere 88 pounds.\u00a0Working or navigating mountains of paperwork on top of her illness would have been impossible.\u00a0\u00a0<\/p>\n

Her experience\u00a0isn\u2019t\u00a0uncommon. Blood cancer treatments are effective, but they are far from easy to endure. And many patients, like Amanda,\u00a0don\u2019t\u00a0have a smooth return to \u201cnormal life.\u201d\u00a0They\u00a0remain\u00a0immunocompromised; contracting a simple cold could put them back in the hospital, or worse. They must take precautions to minimize their risk \u2014 precautions that can prevent them from sustaining regular employment.\u00a0\u00a0<\/p>\n

Ushering\u00a0cancer patients into an era of extra uncertainty and chaos when their lives are already on the line is wrong. But there\u2019s still time to make it right.\u00a0\u00a0<\/p>\n

Gwen Nichols is a hematologist\/oncologist, cancer researcher, and chief medical officer of Blood Cancer United, formerly The Leukemia & Lymphoma Society.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"In May 2025, I\u00a0joined\u00a0more than 160 blood cancer advocates on Capitol Hill.\u00a0At the time, Congress was considering changes…\n","protected":false},"author":2,"featured_media":36865,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[4],"tags":[21514,1400,21448,8,1177,1452,9,7],"class_list":["post-36864","post","type-post","status-publish","format-standard","has-post-thumbnail","category-top-stories","tag-advocacy","tag-cancer","tag-cms","tag-headlines","tag-hhs","tag-medicaid","tag-news","tag-top-stories"],"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@news\/116694158253518163","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/posts\/36864","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/comments?post=36864"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/posts\/36864\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/media\/36865"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/media?parent=36864"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/categories?post=36864"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/news\/wp-json\/wp\/v2\/tags?post=36864"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}