When
I
started
my
career
as
a
pulmonologist,
my
time
was
spent
caring
for
patients
—
listening
to
their
concerns,
researching
care,
talking
through
treatment
options,
and
monitoring
their
progress.
Now
the
profession
has
devolved
into
mounds
of
paperwork.
I
spend
hours
each
day
completing
prior
authorizations,
battling
insurance
denials,
and
fighting
for
reimbursements,
just
so
my
patients
get
the
recommended
care
and
treatments
they
need.
A
new
federal
rule
implementing
work
reporting
requirements
for
many
people
with
Medicaid
coverage
will
make
this
problem
significantly
worse.
Congress
must
step
in
to
advocate
for
major
changes
to
this
rule.
Otherwise,
patients
will
suffer
and
physicians
will
be
even
more
burdened
with
unnecessary
paperwork.
Last
summer,
Congress
passed
H.R.
1,
which
included
more
than
$1
trillion
in
healthcare
cuts
and
imposed
new
work
requirements
for
Medicaid.
Just
3
months
prior,
in
April
2025,
I
met
a
woman
who
shared
a
particularly
impactful
story
in
an
effort
to
urge
Congress
to
protect
her
access
to
Medicaid.
She’d
lost
her
job
just
a
few
weeks
before
she
was
diagnosed
with
lung
cancer,
leaving
her
to
face
a
cancer
diagnosis
without
an
income
or
healthcare
coverage.
But
because
she
qualified
for
Medicaid,
she
was
able
to
access
the
biomarker
testing
and
treatments
she
needed.
Carla
told
members
of
Congress
that
Medicaid
saved
her
life.
When
H.R.
1
was
being
considered,
lawmakers
repeatedly
promised
that
people
with
serious
health
conditions,
like
Carla,
would
be
protected
from
losing
coverage
due
to
the
work
requirements.
But
in
June
this
year,
the
Centers
for
Medicare
&
Medicaid
Services
(CMS)
released
an
interim
final
rule
that
threatens
Medicaid
access
for
millions
of
people
with
serious
or
complex
health
conditions,
including
lung
cancer
and
chronic
lung
disease.
The
rule
makes
it
much
harder
for
patients
to
qualify
for
medical
exemptions
from
work
requirements
and
adds
unnecessary
red
tape.
Under
the
new
rule,
having
a
serious
condition
is
not
enough
to
qualify
for
an
exemption
—
state
Medicaid
programs
are
required
to
verify
that
the
condition
“significantly
impairs”
the
patient’s
ability
to
comply
with
work
requirements.
There
are
many
unanswered
questions
about
how
this
will
work
in
practice.
On
the
clinician
side,
will
physicians
and
other
healthcare
providers
be
expected
to
make
these
determinations?
Many
providers,
like
me,
may
feel
these
determinations
are
outside
of
our
areas
of
expertise.
This
will
also
be
a
huge
administrative
burden
for
clinicians,
who
are
already
overburdened
with
paperwork
that
pulls
our
time
and
attention
away
from
what’s
most
important:
caring
for
patients.
Meanwhile,
people
living
with
conditions
such
as
lung
cancer,
chronic
obstructive
pulmonary
disease
(COPD),
and
pulmonary
fibrosis
are
already
dealing
with
complex
health
challenges,
including
ongoing
treatments,
hospitalizations,
and
frequent
medical
appointments.
Requiring
them
to
repeatedly
navigate
confusing,
burdensome
paperwork
requirements
will
lead
many
to
lose
healthcare
coverage
when
they
need
it
most.
Loss
of
Medicaid
coverage
will
not
make
these
patients’
chronic
medical
conditions
go
away,
and
ultimately,
they
will
still
require
care
at
a
higher
cost
to
an
already
burdened
healthcare
system.
We
are
already
seeing
many
hospitals
and
healthcare
systems
struggle
to
maintain
financial
viability,
particularly
in
underserved
rural
and
inner-city
locations.
The
loss
of
a
robust
health
safety
net
combined
with
other
ongoing
cuts
to
public
health
puts
us
all
at
risk.
Prior
efforts
at
instituting
Medicaid
work
requirements
at
the
state
level
have
shown
that
these
requirements
take
away
coverage
from
eligible
people
and
lead
to
substantial
administrative
costs.
They
also
fail
to
boost
employment.
We
will
likely
see
the
same
results
when
implementing
these
requirements
nationwide,
with
coverage
losses
on
a
much
larger
scale.
There
is
no
way
to
implement
work
reporting
requirements
that
does
not
hurt
people’s
access
to
critical
healthcare
coverage.
And
this
new
rule
makes
an
already
harmful
policy
even
more
unworkable
for
both
physicians
and
our
patients.
I
call
on
members
of
Congress
to
take
immediate
action
by
asking
CMS
to
fix
this
rule
and
protect
patients’
access
to
Medicaid
coverage.
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