Court decision on ‘frailty’ a win for Medicaid recipients

Medicaid recipients who are in substance use disorder (SUD) treatment or the first five years of recovery are exempt from work requirements, but they have to prove this. This is not new. What is new is that if they qualify as exempt because they are medically frail, they no longer have to also prove that frailty means they are too impaired to work. On October 29 a ruling from the U.S. District Court in Massachusetts eliminated the second requirement. In the suit, in which 26 states sued the Center for Medicare and Medicaid Services (CMS), Judge Stearns said it was using an unlawful definition of “medically frail.” The IFR – the Trump Administration's CMS – went beyond H.R. 1 in choosing its own definition and narrowing the number of people who would be eligible for Medicaid.