The government is trying to make it harder for people to get Medicaid. Keep reading to find out what is going on and how you can take action.

What is happening with Medicaid right now?

Many disabled people get health care and services through Medicaid. Medicaid is a health care program run by state governments. Medicaid helps many people get health care. Many people with disabilities and many people who don’t have a lot of money use Medicaid. Medicaid expansion is a type of Medicaid adults can get if they do not make a lot of money. 

H.R. 1 is a law that Congress passed last year. It took away almost $1 trillion dollars from Medicaid. H.R. 1 also puts work requirements into programs like Medicaid expansion. Work requirements are when people have to prove they are working to get health care. The Centers for Medicare and Medicaid Services (CMS) made a new rule about work requirements. CMS is the part of the government that makes rules about Medicaid.

Some states have Medicaid expansion programs. Medicaid expansion programs have different names in different states. You can find the name and website of your state’s Medicaid expansion program here. Some states have programs that are like Medicaid expansion but are not Medicaid expansion. States made these programs to give health care to people who could not get Medicaid some other way. Some people who get Medicaid from these programs will also have to follow work requirements. These programs are: 

• Georgia–Pathways to Coverage: Pathways population and ESI/HIPP 
• Hawaii–QUEST Integration: Populations 1,4, and 5 
• Massachusetts–MassHealth: e-HIV/Family Assistance + TANF and EAEDC 
• New York–Medicaid Redesign Team: TANF 
• Oregon–Oregon Health Plan: Youth with Special Health Care Needs 
• Tennessee–TennCare III: Parent/Caretaker Relatives Expansion 
• Utah–Utah Medicaid Reform: Adult Expansion Population and Targeted Adults 
• Wisconsin–Badgercare Reform: Childless Adult Demonstration Population 

If you are not sure if you are part of one of these programs, talk to your state Medicaid agency. In our resources, ASAN calls both Medicaid expansion and these other programs, “programs like Medicaid expansion”.

H.R. 1 said people who are “medically frail” do not have to work to get Medicaid. Many people and state governments thought they knew what H.R. 1 meant by “medically frail.” They thought H.R. 1 said people are medically frail if they have certain disabilities or serious health conditions. A serious health condition can mean something like cancer, HIV/AIDS, and other health conditions.

But CMS disagrees. The new rule says there are two things that make someone medically frail. One is having some kind of disability or serious health condition. The second is you need to prove you can’t work because of that disability or serious health condition.

If your state thinks you can work, you will have to work to get health care from Medicaid expansion or programs like Medicaid expansion. This is true even if:

• You can’t actually work
• You can’t find an accessible job
• You can’t take steps needed to work, like paying to go to college 

We still don’t know how people will be able to prove they can’t work.

This rule is a bad rule. A lot of people who use programs like Medicaid expansion to get health care will lose their health care because of this rule. That is why we need everyone to take action against this bad rule!

What can we do about this bad rule?

One way we can take action is by talking to legislators about this bad rule. Legislators vote on laws. Legislators for the whole country are part of Congress. Congress is the part of the federal government that makes laws. There are two parts to Congress. One is the Senate and one is the House of Representatives. Legislators in the Senate are called Senators. People in the House of Representatives are called Representatives. [Both are called members of Congress.]

Representatives and Senators can tell CMS to change the rule. They can also tell CMS to delay the rule. Delaying the rule means that states will not have to follow the rule until later. This action alert will tell you how to call or email your members of Congress’ offices about this bad rule.

There are also state legislators. State legislators vote on laws that affect their state. For example, a state legislator in Arizona votes on laws that affect Arizona. Your state usually has two kinds of state legislators. 

One is a State Senator. A state Senator is a legislator in the state Senate. 

Another is a State House. A state Representative is a member of a state’s House. Some states call state Representatives something else. Some examples are State Assemblymen, State Representatives, and Delegates. In this action alert, we will call all legislators who work for the State House “State Representatives”.

State legislators can also tell CMS to change and delay the bad rule. This action alert will tell you how to call or email your state legislators’ offices about this bad rule.

Telling state and federal legislators how you feel about the rule is important. It is a way to stand up for people who get health care through programs like Medicaid expansion. You can tell your legislators that you want them to ask CMS  to change the rule and delay it. In this action alert, we will tell you how to contact your legislators about the rule. We will also give you ideas about what you can say to your legislators about the rule.

How can I call my federal legislators about this bad rule?

• If you are not sure who your legislators are, you can find out here.

• Go to this website.
  1. Click on “Representatives”. 
  2. Search for your state. 
  3. Click on your Representative’s name. This will take you to your Representative’s website.

• On your Representative’s website, look for a list of office locations. Every Representative’s website is different. Here are some common places to find the list of office locations:
  1. You may need to search “office locations” in the search bar on the website. 
  2. You may need to scroll down to the bottom of the home page.
  3. You may need to click “Contact” on the menu bar. 

• Find the Washington, DC office location.
  
• You can call the phone number listed with the DC office.

• You can follow most of the same steps above to call your Senator. The only thing that changes is that you will click on “Senators” in step two instead of “Representatives”.

What can I say when I call my federal legislators?

Here is a script you can use when you call your legislator’s office. Be sure to fill in the bolded parts of the script with your own information:

“Hi, my name is [your name]. I am a constituent of [Representative/Senator NAME]. I am calling today to ask the [Representative/Senator] to urge the Center for Medicare and Medicaid Services to change and delay the recent rule about Medicaid work requirements. The rule will cause millions of people to lose their health care. The definition of medical frailty in the rule is unclear. CMS doesn’t tell the states how we are supposed to prove we are medically frail. That’s going to endanger coverage for people with disabilities on Medicaid like [me/my loved one]. People trying to follow these requirements and people who cannot work are going to lose coverage because the rule is not clear. Please ask [Representative/Senator NAME] to tell CMS that [your state] will not be ready to implement this rule by January 2027. I do not want anyone to lose their health care.

[If you have a personal story about why Medicaid matters to you, you may add that here.]

This rule will cause people in [your state] to lose access to life-saving health care and supports that allow us to live in the community. Congress promised to protect people with disabilities and serious illnesses, and this rule does the opposite. Please tell CMS to delay this rule. Thank you, and have a great rest of your day.”

How can I email my federal legislators about this bad rule?

• If you are not sure who your legislators are, you can find out here.

• Go to this website.
  1. Click on “Representatives”. 
  2. Search for your state. 
  3. Click on your Representative’s name. This will take you to your Representative’s website.

• Most Representatives have a form on their website to get messages. They want people to fill out this form instead of sending an email. Here is how to find the form.
  1. On your Representative’s website, look for a button that says “Contact” or “Email”.
  2. When you click on the button that says “Contact” or “Email”, you might be asked to type in your ZIP Code. This is to make sure that you are a constituent.
  3. After you enter your ZIP Code, a form will pop up. You can fill in your contact information and write your message.

• You can follow most of the same steps above to email your Senator. The only thing that changes is that you will click on “Senators” in step two instead of “Representatives”.

What can I write when I email my federal legislators?

Here is a script you can use when you email your legislator’s office. Be sure to fill in the bolded parts of the script with your own information:

Dear [Representative/Senator NAME]

I live in [town/city] and I am your constituent. I am writing to ask you to urge the Center for Medicare and Medicaid Services to change and delay the recent rule about Medicaid work requirements. The rule will cause millions of people to lose their health care. The definition of medical frailty in the rule is unclear. CMS doesn’t tell the states how we are supposed to prove we are medically frail. That’s going to endanger coverage for people with disabilities on Medicaid like [me/my loved one].  Please tell CMS that [your state] will not be ready to implement this rule by January 2027. I do not want anyone to lose their health care.

[If you have a personal story about why Medicaid matters to you, you may add that here.]

This rule will cause people in [your state] to lose access to life-saving health care and supports that allow us to live in the community. Congress promised to protect people with disabilities and serious illnesses, and this rule does the opposite. Please tell CMS to delay this rule. Thank you, and have a great rest of your day.

Sincerely,

Your name 

Your home address [This shows that you live in the place your legislator represents.] 

Your phone number 

Your email address

How can I call my state legislators about this bad rule? 

• Go to this website. 
• Type in your address and postal code. Another name for a postal code is a ZIP code.
• Click “Find Your Officials”. 
• Click the name of your state. 
• Scroll down to find your state Senator and your state Representative. 
• Call the phone number next to your state Senator’s and state Representative’s names. 

What can I say when I call my state legislators? 

Here is a script you can use when you call your state legislator’s office. Be sure to fill in the bolded parts of the script with your own information:

“Hi, my name is [your name]. I am a constituent of [Representative/Senator NAME]. I am calling today to ask the [Representative/Senator] to tell our governor and state Medicaid director to urge the Center for Medicare and Medicaid Services to change and delay the recent rule about Medicaid work requirements. The rule will cause millions of people to lose their health care. The definition of medical frailty in the rule is unclear. CMS doesn’t tell the states how we are supposed to prove we are medically frail. That’s going to endanger coverage for people with disabilities on Medicaid like [me/my loved one].  Please ask [Representative/Senator NAME] to tell our governor, state Medicaid director, and CMS that [your state] will not be ready to implement this rule by January 2027. I do not want anyone to lose their health care.

[If you have a personal story about why Medicaid matters to you, you may add that here.]

This rule will cause people in [your state] to lose access to life-saving health care and supports that allow us to live in the community. [Your state] legislators promised to protect people with disabilities and serious illnesses, and this rule does the opposite. Please do whatever you can to get CMS to delay this rule. Thank you, and have a great rest of your day.”

How can I email my state legislators about this bad rule? 

• Go to this website. 
• Type in your address and postal code. Another name for a postal code is a ZIP code.
• Click “Find Your Officials”. 
• Click the name of your state. 
• Scroll down to find your state Senator and your state Representative. 
• Click the envelope icon next to your state Senator’s and state Representative’s names. This will show you their email address.

What can I write when I email my federal legislators?

Here is a script you can use when you email your state legislator’s office. Be sure to fill in the bolded parts of the script with your own information:

Dear [Representative/Senator NAME]

I live in [town/city] and I am your constituent. I am writing to ask you to tell our governor and state Medicaid director to urge the Center for Medicare and Medicaid Services (CMS) to change and delay the recent rule about Medicaid work requirements.  The rule will cause millions of people to lose their health care. The definition of medical frailty in the rule is unclear. CMS doesn’t tell the states how we are supposed to prove we are medically frail. That’s going to endanger coverage for people with disabilities on Medicaid like [me/my loved one]. Please tell CMS that [your state] will not be ready to implement this rule by January 2027. I do not want anyone to lose their health care.

[If you have a personal story about why Medicaid matters to you, you may add that here.]

This rule will cause people in [your state] to lose access to life-saving health care and supports that allow us to live in the community. [Your state] legislators promised to protect people with disabilities and serious illnesses, and this rule does the opposite. Please do whatever you can to get CMS to delay this rule. Thank you, and have a great rest of your day.

Sincerely,

Your name 

Your home address [This shows that you live in the place your legislator represents.]  

Your phone number 

Your email address

ASAN would love to know how about the responses you get to your phone calls and emails! If you want to share your experience with us, please email Jules Good, ASAN’s State Advocacy Manager, at [email protected] . 

Thank you for taking action to defend Medicaid and protect health care for the disabled community!