Six states will require proof for Medicaid work-rule exemptions

Associated Press

As Medicaid work rules for some beneficiaries begin in January, Arkansas, Idaho, Indiana, New Hampshire, North Carolina and Ohio will require documentation for medical exemptions immediately, rather than accept self-attestation during the first year.

The mandate covers up to 20 million lower-income adults without children at home enrolled through Medicaid expansion in 40 states and D.C.; the 10 states that did not expand Medicaid are excluded. Covered people must work or volunteer at least 80 hours a month or attend school at least half-time, with exceptions including medical frailty. The Congressional Budget Office projected $887 billion in federal savings over 10 years and 7.5 million fewer people insured. Democrats in 25 states are suing, arguing the rules are too harsh.

Federal rules allow self-attestation during the first year; starting in 2028, states may accept it once at enrollment, then must require documentation at least every 12 months. A June rule from the Centers for Medicare and Medicaid Services says a condition must “significantly impair” a person’s ability to work, volunteer or attend school to qualify for the medical-frailty exception. Supporters say documentation helps prevent fraud, while patient advocates warn it could keep eligible people from coverage.

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