Sen. Ron Wyden (D-Ore.) and Rep. Frank Pallone Jr. (D-N.J.), who will likely lead the top committees with health jurisdiction next year, called on Trump administration officials to use their “discretion to give states additional time to implement work reporting requirements and protect eligible beneficiaries from losing coverage.”
The letter comes amid mounting uncertainty for states just weeks before the implementation deadline.
Under the One Big Beautiful Bill Act, Medicaid expansion states must enact new Medicaid work reporting requirements beginning on Jan. 1, 2027.
The provision requires Medicaid enrollees between the ages of 19 and 65 to work, participate in community service, or attend an education program for at least 80 hours a month.
Republicans included a carve-out for people who are “medically frail,” and the Centers for Medicare and Medicaid Services published a rule telling states how that term should be defined.
But the administration’s definition was much more restrictive than what states had prepared for, leading to some suing the administration.
Implementation of that provision was paused last month by a federal judge, who found that the administration's definition of "medically frail" was unlawful.
But the administration plans to appeal the ruling, and the issue may not be resolved for months, creating enormous uncertainty for states about what the rules will be less than two months before the paperwork requirements take effect.
Failure “to permit states to delay implementation despite known operational deficiencies will worsen preventable coverage losses for which Congressional Democrats will hold the Trump Administration accountable,” the lawmakers wrote.
Pallone and Wyden noted that one of Democrats’ top priorities early next year will be repealing the nearly $1 trillion Medicaid cuts enacted under the OBBBA.
But until Congress acts, the lawmakers said CMS has a responsibility to carry out the law as Congress intended, “and to ensure that implementation does not unnecessarily jeopardize coverage for eligible beneficiaries.”
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