What is happening with Medicaid?

Last year, Congress passed a new Medicaid law.

The law created new community engagement rules (often called work requirements) for some adults who get Medicaid.

It impacts all but 7 states: Alabama, Florida, Kansas, Mississippi, South Carolina, Texas, and Wyoming.

Work requirements say some adults may have to work, go to school, volunteer, or do another approved activity to keep Medicaid.

For most states, the work requirements will begin on January 1, 2027.

Why does this matter?

Medicaid helps people with disabilities get healthcare and daily support.

Medicaid can pay for:

• Doctor visits
• Medicine
• Therapy
• Mental health care
• Personal care services
• Help at home
• Support to live in the community
• Help finding and keeping a job

Losing Medicaid for even a short time can mean losing important care and support.

What do the rules mean for people with disabilities?

Many people with disabilities do not have to follow the work requirements.

For example, many people who get Supplemental Security Income (SSI) qualify for an “exemption” and do not have to meet the work requirements.

An exemption means a person does not have to follow the work requirements.

But some people with disabilities may still have to show they qualify for an exemption. This may include:

• Adults with disabilities who do not get SSI
• People waiting to learn if they qualify for disability benefits
• People who lose SSI for a short time because of paperwork problems
• Young adults with disabilities moving from children’s services to adult services

Some people with disabilities can qualify for an exemption if they are considered “medically frail.”

Medically frail means they have a disability or serious health problem that makes it hard to meet the work requirements.

People who want to qualify for this medically frail exemption may have to show:

• They have a disability or serious health problem
• Their disability or health problem makes it hard to meet the work requirements

Some people who qualify for an exemption may still have trouble getting one.

Do family caregivers also qualify for an exemption?

Some family caregivers may also qualify for an exemption.

This may include parents, guardians, relatives, and other caregivers who regularly help a person with a disability.

Caregivers may still have to show they qualify.

How could paperwork make someone lose Medicaid?

Even people who qualify for an exemption could lose Medicaid if their paperwork is missing, delayed, or filled out incorrectly.

We have seen this happen before. Some people who should have kept their Medicaid lost it because of paperwork problems, not because they no longer qualified.

Why is The Arc concerned?

The law was meant to protect people with disabilities and family caregivers from work requirements.

The new rule makes many changes that make it harder for people to show they qualify for an exemption. More people with disabilities may not be protected because of these changes.

People should not lose healthcare because of confusing rules, paperwork problems, or mistakes.

Take action!

The federal government is accepting public comments on this rule until July 31, 2026.

Share your comments and stories through The Arc’s website.

Tell CMS to:

• Withdraw or pause the rule
• Make it easier for people with disabilities and serious health problems to qualify for the medically frail exemption
• Protect people from losing Medicaid because of paperwork problems

Your story can help protect Medicaid and the services people use every day.