Hospitals Brace for Medicaid Work Rules and Deep Funding Cuts

Hospitals across the country are mobilizing an expansive outreach effort in an attempt to ensure that roughly 19 million patients do not lose their insurance coverage under new Medicaid work rules that begin in January.

Saying the requirements are generating widespread anxiety and confusion, health care executives are using a variety of methods to help guide the Americans who will be affected. They are deploying staff and volunteers to contact patients with text messages, phone calls and offers of help.

The rules dictate that able-bodied adults without young children either work, volunteer or attend school or job training for at least 80 hours a month. Republicans included the rules last year as part of President Trump’s package of tax cuts and reductions in safety net spending, including nearly $1 trillion in Medicaid cuts.

Hospitals and other health centers are detailing what evidence people in many cases must provide — pay stubs or other proof of work or school attendance — to maintain coverage.

“There’s going to be people who fall through the cracks,” said Nicole Harper, chief financial officer at Eskenazi Health, a safety-net hospital in Indianapolis. “We’re bracing for impact.”

Because hospitals are heavily reliant on Medicaid funding, keeping a stable patient population is critical for them to maintain government reimbursements.