Health News Illinois
Illinois joined two dozen other Democratic-led states on Monday to sue the Trump administration over its recent guidance on new Medicaid work requirements for those deemed “medically frail.”
The lawsuit argues that an interim final rule released earlier this month by the Centers for Medicare and Medicaid Services oversteps the text of last year’s law that outlines the changes to the Medicaid program.
Specifically, the Democratic coalition said CMS’s “narrow” interpretation of parts of the statute, like the new limits to a medical frailty exemption, will create coverage barriers and prevent eligible residents from receiving necessary care.
While the law said medically frail people include those who have substance use disorders, disabilities or serious medical conditions, CMS said earlier this month someone’s condition must “significantly impair” their ability to work, volunteer or attend school at the rates required in the law for them to be granted an exemption.
CMS said when it unveiled the rules that they were “commonsense measures” to eliminate fraud and preserve benefits for those who need them most.
But the lawsuit said that Congress never stated that an individual’s ability to work must be impaired in order to be “medically frail or otherwise have special medical needs or to have a ‘serious or complex medical condition.”
“Congress clearly stated that our most vulnerable residents, including people living with disabilities or struggling with serious medical conditions, shouldn’t have to jump through hoops to qualify for lifesaving medical coverage,” Illinois Attorney General Kwame Raoul said. “No one should have to work through a pile of papers from their hospital bed to prove that they’re too sick to work.”
The coalition also argues that the rule will harm states, Medicaid beneficiaries, healthcare providers and state healthcare systems, and unconstitutionally coerce states by imposing new compliance requirements after they have already started implementing the law based on its language and prior CMS guidance.
CMS and the U.S. Department of Health and Human Services did not return a request for comment on the lawsuit.
Raoul was joined in the lawsuit by attorneys general from 23 states and the District of Columbia, as well as governors from Kentucky and Pennsylvania.
Starting next year, Medicaid enrollees between 19 and 64 years old will have to show that they work or do community service at least 80 hours a month, or are in school at least half the time. There are exceptions for those considered medically frail or in addiction treatment programs, among others.