Medicaid

Democratic attorneys general and the Justice Department are facing off for the first time in court Tuesday over the fine line between being sick and being “medically frail,” a distinction that could cost Medicaid recipients their health benefits.

Some states are turning Medicaid on before some people leave jail or prison, with the goal of making sure they have a better chance of staying out of jail and staying alive. But just as 19 states race to build these programs, Medicaid itself is changing.

Final regulations issued in June say people can obtain an exemption if they’re “medically frail,” or too sick or disabled to work, which may require them to submit documentation from a medical professional.

The Trump administration’s crackdown on Medicaid fraud in Minnesota has upended finances and disrupted access to care.

Starting next year in most states, many adults enrolled in Medicaid will have to prove they work, are enrolled in college or vocational courses, volunteer, or do unpaid work for at least 80 hours a month. Advocates say this could pose a significant challenge to Medicaid-eligible farmworkers, who frequently work more than 80 hours a month during harvest season but less in other months.

Democrats in 25 states and the District of Columbia on Monday sued the Trump administration over its recent guidance on new Medicaid work requirements, arguing the strict rules will prevent eligible Americans from accessing the care they need.

A government report ignored evidence and misinterpreted research.

About 55% of Medicaid enrollees are completely unaware that work requirements will become a condition of eligibility starting January 2027. An additional 27% say they have heard something but are unsure of the details.

Trump administration wants ill recipients to prove they can’t work every six months. Doctors, advocates and state officials wonder how.