Trump Admin: 'Nearly Dead' No Excuse For Not Working For Your Medicaid
Under a new rule, even being under hospice care won't automatically exempt you from the new Medicaid work requirements.
Last year, Donald Trump used his Big Beautiful Bill to give a whopping $2.3 trillion tax cut to the wealthiest 10 percent of Americans. How nice for them! It’s not clear what more they’ll actually be able to purchase with all that extra money, given that they probably already have everything they need, but I’m sure it brought a smile to more than a few of their faces. And isn’t that what really matters?
The one problem with that plan, however was how to pay for said tax cut, while still paying douchebags to kidnap migrants and kill peaceful protesters and funding this war that no one (except maybe one recently deceased fella) really wants. After all, the House did just pass a $1.5 trillion defense bill.
Well, don’t worry your pretty little head about that, because they’ve got some plans in the works. On Thursday, US District Judge Richard Stearns of Massachusetts (a Clinton appointee) denied a request from Democratic attorneys general of 25 states and the District of Columbia to postpone the implementation of a new rule that would require Medicaid patients with terminal diseases to prove that they are too “medically frail” to be able to work 80 hours a month or be cut off entirely.
And don’t you go thinking that being in literal hospice or palliative care is an excuse, or that a note from your doctor counts as “proof” that would automatically allow an exemption from the work requirements. Or that a late-stage cancer or HIV/AIDS diagnosis would provide an automatic exemption. Because they don’t. You can be on your literal deathbed and you will need to convince some random bureaucrats that you really are too sick to work, in order to not get kicked out of it.
Under normal circumstances, when slightly more normal human beings are in charge, being at or below 138 percent of the poverty line and having a terminal diagnosis — meaning you only have around six months left to live — is enough to qualify for Medicaid. Now, the Trump administration wants to require that these people work, volunteer or go to school for 80 hours a month or fill out an ungodly amount of paperwork to prove that they are “medically frail or otherwise have special medical needs.” They will also need to demonstrate that their condition will “significantly impair” their ability to work. The rule does exempt those with “serious or complex medical conditions,” but does not state what those conditions might be.
Via Politico:
Democratic attorneys general from 25 states and Washington, D.C. [argued that] the rule is both too strict, in not offering blanket exemptions to people with certain diseases, and too vague, in failing to guide states on how to determine who is too sick to work — and [asked] the judge to block the stricter medical frailty policy.
“This is one of those cases where it’s really hard to overstate how dire the consequences could be,” said North Carolina’s Democratic attorney general, Jeff Jackson, who has joined the lawsuit with other Democratic state officials challenging the policy. “You’re going to have 50 states doing 50 different things, and we’re all going to have to create a whole new bureaucracy. …You are talking about a lot more paperwork, more evaluations, more doctor visits, and a lot more work for doctors themselves.”
According to the Congressional Budget Office, the changes made by the Trump administration to healthcare policy will result in about 12 million people becoming uninsured, about half of whom will be Medicaid recipients who failed to meet the new eligibility requirements or “because of procedural reasons (such as missed paperwork), because of problems with communication, or because of difficulty with navigating reenrollment.”
It’s not especially easy to navigate bureaucracy while also being very, very sick — and that’s not meant to be a bug, but a feature. Rather than making unpopular cuts to programs, the Trump administration seems to have gone the route of simply requiring that people who receive any kind of assistance fill out a ridiculous amount of paperwork, in the hope that they will just give up or screw it up somehow.
Via Common Dreams:
[In an article for Real News Network published earlier this week, Taya Graham and Stephen Janis] wrote that what has happened to recipients of the Supplemental Nutrition Assistance Program (SNAP) illustrates how burdensome these new requirements may become.
As The New York Times reported earlier this month, in Arizona, 440,000 people have already been dropped from SNAP after it enacted a formidable regime of paperwork for low-income recipients to prove eligibility, including requiring some people with panhandling income to obtain documentation from donors who drop them a buck on the street.
“If this is what people receiving SNAP benefits have been subjected to,” Graham and Janis wrote, “imagine what’s going to happen to people who will need to navigate the new [Medicaid] requirements while struggling with a debilitating or terminal illness.”
Nothing good, we’d imagine.
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According to a March 2026 Gallup poll, 61 percent of US Americans say they worry “a great deal” about health care access and affordability. The concern ranked higher than 15 other domestic issues, including the economy (51 percent) and inflation (50 percent). In fact, only 6 percent say they don’t worry about it at all. Fully two-thirds (66.5 percent) of bankruptcies in the United States are caused by medical bills. Three in 10 Americans say that either they or someone in their household has had trouble paying medical bills in the last year.
The fact that we live this way, that we are planning to kick poor cancer patients off of Medicaid at a time when practically every other modern nation has universal healthcare, is beyond obscene, even more so because that money is going to go to invading other countries instead of taking care of our own citizens.
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"It’s not especially easy to navigate bureaucracy while also being very, very sick". Fuck, it's not easy even if you are perfectly well, and have an advanced degree.
Trump was promising you'd have the greatest healthcare and it would cost way less. His healthcare plan is going to be rolled out in two weeks. Of course, what you get is not that. It is the opposite of that. We need single payer. But even if you did not have that, there are dozens of things you could do, through legislation or rule changes, to actually improve health outcomes and reduce costs for patients. Republicans are doing none of those things, because they hate spending money on lower-income people, and because of the general rule they have: if I'm not personally hurting, there's no problem.