Lawsuit challenges ‘medically frail’ exemption

Lawsuit challenges ‘medically frail’ exemption

What does it mean to be “medically frail?” A new lawsuit is challenging how the Trump administration plans to exempt medically frail people from Medicaid work requirements.

Medicaid enrollees, alongside several major health care advocacy organizations and the city of Columbus, Ohio, said the administration’s final rule implementing work requirements is not what Congress intended.

They argue the rule narrowly defines who qualifies for the law’s medical frailty exclusion, putting people with serious physical and mental health conditions at risk of losing Medicaid because of new reporting and verification requirements, even though Congress categorically excluded medically frail people from the requirements.

The coalition is asking a federal court in Maryland to vacate the rule, alleging it’s “arbitrary and capricious and contrary to law.” The suit also alleges violations of the Administrative Procedure Act, the law governing how regulations are issued.

The work requirements are set to take effect in January . Beneficiaries who are part of the Medicaid expansion population must work or volunteer at least 80 hours per month, attend school at least part time or participate in job training.

Expansion states are responsible for ensuring working-age recipients are meeting the requirement unless they are disabled, caring for young children or have a serious health condition.

The rule implicitly links the definition of medical frailty to a person’s ability to work. To qualify for an exemption, a person must demonstrate that their condition prevented them from meeting the work requirement.

The lawsuit is the latest attempt to challenge the work requirements. In June, about two dozen states sued the Trump administration over the “medically frail” definition. A federal judge in July denied the states’ request to block the rule while the lawsuit is agued.

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How policy will be impacting the healthcare sector this week and beyond:

The White House is backing down from a plan to issue an executive order that would give the White House control over scientific grants from the National Institutes of Health, Sen. Susan Collins (R-Maine) said. Collins, chair of the Senate Appropriations Committee, has been pressuring the White House Office of Management and Budget all week to drop the idea, and said officials conveyed to her they will not be moving forward. …

MEMPHIS, Tenn. (WREG) – Kratom, an herbal substance whose components are opioid-related, was found in the investigation into two student deaths at the University of Mississippi, the local narcotics team said on Tuesday. The students were found dead on Monday, the Lafayette County Metro Narcotics team, in Oxford, Mississippi, said. While officers were investigating the deaths, they found “packaged kratom” bought …

Supreme Court Justice Elena Kagan declined a surrogate’s emergency bid on Tuesday to intervene in her custody fight that drew national attention after the biological parents’ told her to get an abortion and she left for Texas instead. McKenna West, the surrogate, sought to lift a parentage judgment in favor of the couple issued in a California court, where they reside. West said the case needed to be litigated …

For Insiders: Trawling fight makes waves in Alaska Senate contest

The race for Senate in Alaska, one of Democrats’ best hopes this year for retaking a seat in the upper chamber, has a lot to do with fish.

Local and state headlines on healthcare:

Colorado health insurance premiums expected to jump by 10% next year ( Colorado Newsline )

Rural Missouri families face longer drives, riskier births as maternity wards vanish ( Missouri Independent )

Health news we’ve flagged from other outlets:

RFK Jr.’s enhanced security was funded with money from minority health office ( Wall Street Journal )

Hospitals shutter youth gender clinics in deal with Trump administration ( New York Times )

A private equity-owned hospital chain is becoming a nonprofit. Is it just a bailout for investors? ( Stat )

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