Five governors ask HHS to delay Medicaid work requirements
- Five governors asked HHS to delay the Jan. 1 Medicaid work requirement deadline.
- The requirement applies to roughly 21 million ACA expansion enrollees.
- The governors say a June CMS rule changed states’ implementation plans.
- Nebraska has denied almost 470 applicants for missing verification information.
WASHINGTON, D.C., UNITED STATES — Five Democratic governors have asked the U.S. Department of Health and Human Services (HHS) to delay the Jan. 1 deadline for states to comply with Medicaid work requirements, saying shifting federal guidance has made the date impossible to meet safely.
The governors of Oregon, California, Maine, New Mexico and Virginia sent the letter to HHS Secretary Robert F. Kennedy Jr. on Thursday, asking for a reasonable extension to minimize avoidable disruptions in coverage.
States say a June rule changed the plan
The national mandate ties Medicaid eligibility to beneficiaries’ work, education or volunteering hours and applies to the roughly 21 million people who gained eligibility through the Affordable Care Act (ACA) expansion, Healthcare Dive reported.
States had 18 months to remake their data and eligibility systems, expand outreach and track compliance, with minimal federal funding.
The governors said an interim final rule (IFR) that the Centers for Medicare and Medicaid Services (CMS) released in June went beyond the law, citing stricter rules on how medically frail people prove they cannot work and unexpected changes to state verification systems.
“These are not minor or technical adjustments. They fundamentally change the processes and system logic underlying states’ implementation plans,” the letter reads.
The governors asked HHS to delay the compliance date and “work with states to establish a realistic implementation timeline.”
It is Oregon Gov. Tina Kotek’s second attempt to push back the requirements, after a May letter that her office said the administration never answered.
Early data shows paperwork denials
More than two dozen states are suing the administration over the rule, though a judge has allowed it to remain in effect while the case proceeds.
Some Republican-led states are enforcing stricter rules than required, skipping one-year grace periods or racing to launch before the Jan. 1 start date.
Nebraska, the first state to implement work requirements in May, has denied almost 560 new applicants subject to the rules, about 470 of them because they could not provide the information needed to verify compliance.
About 530 people renewing coverage have been removed from the program, 92% because they did not respond to verification requests.
For state agencies and the health plans that serve Medicaid members, the requirements add a large volume of eligibility checks, documentation follow-up and member outreach.
Many are weighing healthcare outsourcing and customer service support to handle that verification workload, and comparing options among the top U.S. healthcare outsourcing companies before the Jan. 1, 2027 start date.
Related news
- CMS freezes new ACA broker sign-ups as it cuts 760,000 enrollees · 2 Oct
- CMS proposes Medicare lab cuts to save $1Bn a year · 3 Oct
- Health systems lean into outsourcing to cut costs · 5 Sep
Disclosure: Outsource Accelerator uses AI tools in the backend of its editorial workflow. Every article is reviewed and verified by a human editor before publication.
Stay ahead in healthcare outsourcing. Join thousands of healthcare and business leaders who rely on Outsource Accelerator for the news, trends, and expert insights shaping medical BPO and the future of care delivery. Subscribe to our free newsletter and never miss an update.
