Patient Advocate Groups Challenge Medicaid Engagement Requirements

May 14, 2021 by Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

The American Cancer Society (ACS), along with 14 other healthcare groups advocating for increased access to care, filed an amicus curiae (https://www.fightcancer.org/news/medicaid-work-requirements)—Latin for “friend of the court”—urging the U.S. Supreme Court to deny state imposition of engagement requirements (https://www.fightcancer.org/news/medicaid-work-requirements), like monthly community service, for Medicaid beneficiaries. The U.S. Supreme Court is likely to spend spring deliberating and convey a judgment before the end of summer.

“More than 60% of nonelderly adults with Medicaid already work either full- or part-time,” ACS said in a press release (https://www.fightcancer.org/news/medicaid-work-requirements). “Imposing work requirements could unfairly penalize those unable to work.”

The Obama administration consistently rejected states’ applications for waivers that would tie Medicaid benefits to work and community engagement requirements, but the Trump administration reversed course in January 2018. In Arkansas, the first state to implement requirements (80 hours per month of community service (https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/ar-works-cms-ltr-state-demo-02122021.pdf)), 18,000 enrollees lost coverage in less than a year (https://www.fightcancer.org/news/medicaid-work-requirements), mostly because of the administrative burden associated with the required reporting.  

“Stripping Medicaid enrollees of their health coverage will lead to greater costs for states, both in administrative costs upfront and the costs associated with disenrolling and reenrolling individuals,” the 15 groups said in a joint statement (https://www.fightcancer.org/releases/patient-disability-and-health-care-organizations-urge-us-supreme-court-protect-access).

Seeking to expand Medicaid eligibility (https://voice.ons.org/advocacy/aca-medicaid-expansion-improves-health-and-increases-access-to-care-for-young-adults) is a highly debated issue, but it supports ONS’s commitment to equal access to care for all (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer). Leveraging the courts to change a law through amicus curiae is just one approach; nurses have the power to advocate, too. Get involved in ONS’s Center for Advocacy and Health Policy (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy) and promote the issues that matter most to your patients and practice through letters to the editor and correspondence (https://voice.ons.org/advocacy/get-involved-in-onss-health-policy-advocacy) with your local representatives.


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