New work requirements from Medicaid prompt coverage concerns

Minnesota has new federal guidelines for pending changes to Medicaid work requirements, with stricter rules formally set to take effect Jan. 1.

The rules, pushed by Republicans, require recipients without an exemption to work 80 hours a month through employment, education or community service. States are under pressure to comply with language announced this week by the Trump administration.

Protect Our Care communications director Maddie Twomey said the update does not reassure advocates that vulnerable populations will avoid losing coverage. She said federal changes over the past year related to health-care coverage have already been devastating.

“Nearly 3 million Americans have lost their Medicaid coverage, and that includes over 10,000 people in Minnesota,” Twomey said. “So, this is even before these Medicaid work requirements are taking effect, and the bulk of the coverage losses are going to get worse.”

Protect Our Care says an additional 110,000 Minnesotans could lose coverage.

Exemptions include pregnant women, people with disabilities and parents with young children. But advocates have raised concerns about a narrower definition of medical frailty and warned that enrollees will have to navigate complicated reporting systems.

Federal officials contend the changes create a consistent framework to promote economic stability and self-sufficiency. In the first year, enrollees can self-attest that they have met the work requirements.

Policy analysts say the changes were designed to offset tax cuts from last year’s “One Big Beautiful Bill Act,” with earlier forecasts showing nearly 5 million Americans could be forced off Medicaid.

Twomey said stricter work requirements in states such as Arkansas led people to lose coverage, worsening complex health situations.

“People lost their medications, they lost their ability to see their doctors and to stay healthy,” she said.

As a result, Twomey said, people were put at risk of being out of work, defeating the purpose of the enhanced requirements. A Harvard study said the Arkansas action from 2018 failed to achieve its stated goal of boosting employment.

The Centers for Medicare and Medicaid Services says $200 million is being sent to states to help update reporting systems. But skeptics say most states face budget crunches and that the resources needed to carry out the rule far exceed what is being provided.