Federal officials allow tiered system for Medicaid work exemptions

The short version

• The Centers for Medicare and Medicaid Services issued optional guidance letting states categorize medical frailty into tiers to exempt certain recipients from work mandates.[STAT]
• State agencies face a Jan. 1 deadline to stand up eligibility-check systems, though two dozen states are currently suing over the legality of the requirements.[STAT]
• The Congressional Budget Office projects more than 7 million people will lose coverage, and experts worry administrative hurdles could strip insurance from sick enrollees.[STAT]

Key facts

• CMS issued guidance allowing states to use a tiered system to evaluate medical frailty exemptions for Medicaid work mandates.[STAT]
• States are not obligated to implement the tier structure as they work to set up eligibility checking systems by January 1.[STAT]
• The American Medical Association stated that using a data-driven model could lower documentation burdens for patients and doctors.[STAT]
• Two dozen states have challenged CMS in court, arguing that work rules and frailty verification requirements violate the law.[STAT]

Sources

Outlet counts describe coverage, not independent confirmation. Reports may share a wire service or original source.

• Medicaid will let states use ‘tiers’ to determine medical frailtySTAT metered