Key facts
- States are struggling to implement Medicaid work requirements by the January 1 deadline.
- A federal judge struck down stricter medical frailty rules for exemptions.
- Many states lack the systems to automatically verify work status or medical exemptions.
- Coverage losses are anticipated for eligible enrollees due to implementation challenges.
- CMS has offered states flexibility measures like self-attestation to ease the transition.
States are facing significant challenges in implementing Medicaid work requirements by the January 1 deadline, with many officials warning of readiness issues. Complications arise from the need to verify exemptions for individuals enrolled in school or with medical conditions preventing work, as well as technical limitations in checking eligibility automatically. A recent federal court ruling struck down stricter medical frailty rules, reverting to a more lenient exemption policy. However, states still grapple with developing systems to verify these exemptions and meet the 80-hour monthly requirement for beneficiaries aged 19 to 64.