特朗普政府推行的新政策要求Medicaid受益人每月工作80小时，即使患有癌症、HIV/AIDS或帕金森病等终末期疾病也不自动豁免，必须证明病情严重到无法工作才能获得豁免资格[1]。该政策定于2028年1月1日生效，面向收入在联邦贫困线138%以下的Medicaid扩展受益人[1]。
联邦法官理查德·斯特恩斯周四驳回了25个民主党州及哥伦比亚特区提出的初步禁令请求，诉讼的实质性裁决将在政策生效前进行[1]。美国国会预算办公室预测，未来十年共和党医疗政策变化将导致1180万美国人失去保险，其中570万人为不符合新工作要求或被文件要求绊倒的Medicaid受益人[1]。
北卡罗来纳州民主党检察长杰夫·杰克逊表示："这真的很难夸大后果的严重性...你将有50个州做50种不同的事情"[1]。美国癌症学会癌症行动网络主席丽莎·拉卡塞指出："一个人是否能从癌症诊断中存活下来，最重要的因素之一就是他们是否有健康保险覆盖"[1]。超过4成50岁以上癌症患者在诊断后两年内已耗尽所有资产[1]。亚利桑那州已有440000人因新文件要求从SNAP项目中被删除[1]。
The Trump administration has implemented a policy requiring Medicaid beneficiaries to demonstrate that their condition is severe enough to prevent work in order to obtain an exemption from new monthly work requirements, even when diagnosed with terminal illnesses such as cancer, HIV/AIDS, or Parkinson's disease.[1] The policy mandates that Medicaid expansion beneficiaries work at least 80 hours per month, applicable to individuals with incomes below 138 percent of the federal poverty line.[1]
Twenty-five Democratic-led states and the District of Columbia filed suit seeking to block the policy, but federal judge Richard Stearns rejected their request for a preliminary injunction on Thursday.[1] The substantive ruling on the lawsuit will proceed before the policy takes effect on January 1, 2028.[1] According to the Congressional Budget Office, Republican healthcare policy changes over the next decade are projected to leave 11.8 million Americans uninsured, with 5.7 million of those being Medicaid beneficiaries who either fail to meet work requirements or fall victim to new documentation requirements.[1]
The consequences of these changes extend beyond employment obligations. The American Cancer Society Cancer Action Network chair Lisa Lacasse stated that "one of the most important factors determining whether someone can survive a cancer diagnosis is whether they have health insurance coverage."[1] In Arizona alone, 440,000 people have already been removed from the SNAP program due to new documentation requirements.[1] Additionally, more than 40 percent of cancer patients over age 50 have depleted all their savings within two years of diagnosis.[1]
North Carolina Democratic Attorney General Jeff Jackson warned of fragmented state responses, saying "it's really hard to overstate the severity of the consequences...you're going to have 50 states doing 50 different things."[1]