Listen to article \u2022\u00a00:00 min<\/p>\n
Felix White worries his ability to keep working \u2014 and avoid a health crisis \u2014 could be at risk. <\/p>\n
The 62-year-old Montgomery County<\/a> resident relies on Medicaid to afford the insulin he needs to manage his type 1 diabetes. <\/p>\n Beginning in January, people with Medicaid<\/a> will be required to provide proof that they are working 80 hours a month, unless they are considered too sick to work and qualify for an exemption. <\/p>\n If White fails to submit enough evidence, he could lose Medicaid. Yet without the government-funded coverage, he won\u2019t be able to get the medications and care he needs to stay healthy enough to keep working.<\/p>\n \u201cIt would be a death sentence for me,\u201d White said. <\/p>\n A few years ago, White lost his job in computer science \u2014 and the private health insurance that once covered the medications, glucose monitor, and specialists he needs to manage type 1 diabetes. <\/p>\n Finding work in his field has been challenging at his age, White said. So instead, he\u2019s relied on a string of odd jobs, such as mowing lawns, for income and Medicaid for healthcare. <\/p>\n Pennsylvania expects 310,000 residents<\/a> to lose Medicaid when the new rules take effect, and White fears he could be among them. <\/p>\n The work requirements are part of Republicans<\/a>\u2019 2025 spending and tax cut bill, which is expected to cut more than $900 billion in Medicaid spending over the next 10 years.<\/p>\n The legislation passed by Congress allowed exemptions for Medicaid recipients considered \u201cmedically frail.\u201d The law loosely defined categories of exemptions, such as for people with a substance use disorder, a disabling mental disorder, a \u201cserious or complex\u201d medical condition, and disabilities that limit their daily activities.<\/p>\n White\u2019s Type 1 diabetes is considered a disability that could hinder a person\u2019s ability to work. <\/p>\n But in June, the Centers for Medicare and Medicaid Services provided additional details: To be exempt from the work requirement, people will need to prove not only that they are \u201cmedically frail,\u201d but also that their illness is so severe they are unable to work.<\/p>\n Republicans who pushed the legislation argue that work requirements ensure only people with the greatest needs receive the safety-net support, while helping people who have been sick reintegrate into society.<\/p>\n Pennsylvania is among 25 Democrat-led states suing over the interim final CMS rule<\/a>, which they say oversteps the law, HR 1. The June rule \u201cdiffered significantly\u201d from initial guidance and \u201cundermines months of work and human and financial resources\u201d Pennsylvania has spent to meet the new requirements outlined in HR 1, the Pennsylvania Department of Human Services said in a statement. <\/p>\n \u201cThis redirection poses an even greater threat to health and well-being for Medicaid recipients and the stability of our entire healthcare system,\u201d said Brandon Cwalina, a spokesperson for DHS. <\/p>\n Shifting Medicaid rules<\/p>\n Implementing the new Medicaid rules represents a massive undertaking for states. The law calls for many people to prove on a monthly basis that they are working, and reapply for coverage every six months, instead of once a year. Certain groups of immigrants<\/a> will no longer be eligible. <\/p>\n These changes have required Pennsylvania and other states to overhaul the type of information they document about Medicaid applicants. Processing renewals twice as often will require more staff. <\/p>\n