Colorado Newsline

States Face Coverage Loss Risk as CMS Narrows Medically Frail Definition for Work Requirements

State Medicaid agencies report concerns that sick and disabled enrollees will lose coverage under a narrowed federal definition of "medically frail" used for work requirement exemptions. The change stems from legislation President Trump signed last year requiring states with Medicaid expansion to implement work requirements. State officials fear the tightened criteria will disqualify many enrollees who previously qualified for exemptions, forcing them into compliance or disenrollment. The policy directly affects how managed care organizations identify and retain vulnerable members.