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Trump's New Medicaid Rule 'Designed to Ensure People Lose Healthcare,' Critics Warn
"Today’s announcement marks a grim step in America’s march towards a healthcare system that further restricts access to healthcare and creates barriers rather than delivering affordable healthcare to families."
Jun 02, 2026
The Trump administration on Monday unveiled a rule that is expected to push millions of low-income people off Medicaid by imposing complex bureaucratic barriers in the form of work reporting requirements, which have proven disastrous at the state level.
The rule, released by the Centers for Medicare and Medicaid Services (CMS), marks a key step toward enacting the Republican budget reconciliation package that President Donald Trump signed into law last summer. That measure included around $900 billion in cuts to Medicaid, with new work requirements projected to account for nearly $330 billion of that total.
The new rule will dictate how states must implement the budget law's Medicaid work mandates and who is exempt from the requirements. States are already spending tens of millions of dollars hiring new staff and upgrading technology in preparation for the mandates taking effect next year.
Broadly, the Trump-GOP law requires adults without disabilities between the ages of 19 and 64 to demonstrate at least 80 hours of work, community service, or other "qualifying activities" per month to keep their Medicaid coverage.
Exemptions to the work reporting requirements include people who are pregnant, caregivers to children under the age of 14, or "medically frail." The CMS rule defines the latter category as those with "physical or behavioral health conditions that significantly impair their ability to consistently work or participate in other community engagement activities."
Advocates warned that the rule will force many sick people off coverage. The rule states that people with HIV/AIDS, end-stage renal disease, and cancer would not necessarily be exempt from the work reporting requirements.
According to The New York Times, "states had expected that people with certain serious diagnoses would qualify for the exception, and they had been developing ways to match applications with existing medical records to identify most such people automatically."
"Nebraska’s Medicaid program, which began enforcing a work requirement last month, developed a list of exempted conditions that is nearly 300 pages long," the Times reported. "The state will now need to adjust."
"When these requirements go into effect at the beginning of next year, it’s going to be a complete train wreck for America."
Anthony Wright, executive director of Families USA, said Monday that "far from protecting the vulnerable, this guidance significantly raises the barrier for demonstrating medical frailty, meaning many patients in the middle of treatment will have the new hassle of proving their condition, over and over, with any mistake or gap being penalized by the loss of their healthcare and coverage."
"Through this rule," said Wright, "CMS is requiring duplicative documentation and prohibiting states from taking full advantage of consumer-friendly tools like self-attestation."
During the first year of the work reporting requirements, which are set to take effect nationwide in January 2027, people will be allowed to attest in Medicaid applications that they meet one of the exemptions, according to administration officials.
"Beginning in 2028, states will be expected to verify the exemptions," NBC News reported. "The temporary flexibility, the officials said, is intended to give states time to build systems that can verify exemptions using claims data and other records."
The advocacy group Protect Our Care warned that the new rule "creates a labyrinth of paperwork, reporting mandates, and rigid eligibility rules designed to ensure people lose healthcare, even when they should qualify to keep it."
“Instead of lowering costs or making care more accessible, Republicans are weaponizing government bureaucracy against the American people," said Brad Woodhouse, the president of Protect Our Care. "They are betting that if they make the process confusing and exhausting enough, millions of people will fall through the cracks and lose the care they depend on to survive. Hospitals will suffer, providers will be pushed further to the brink, and families across the country will pay the price while Republicans once again put wealthy donors and corporate greed ahead of the health and well-being of everyday Americans.”
The nonpartisan Congressional Budget Office has projected that, over the next decade, the Trump-GOP work reporting requirements will push nearly 3 million people off Medicaid.
Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, said in a statement that the CMS rule "is the dark heart of the Republican plan to kick millions of working Americans and their children off their health insurance by placing a mountain of paperwork in front of them."
"These barriers are designed to prevent Americans from getting affordable healthcare, while providing a profit bonanza for the corporate consultants who get paid millions to build bureaucratic booby traps," Wyden added. "The Republican plan for healthcare is to kick people when they are down, making sick people sicker and hard times even harder. When these requirements go into effect at the beginning of next year, it’s going to be a complete train wreck for America, and not just for the Americans caught in the bureaucratic maze Republicans have created: Every community will be left with worse healthcare."
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Trump Administration's New Healthcare Plans Could Slap Families With $31,000 Deductibles
"Nobody wants that product," said one healthcare expert of the Trump administration's proposed plans.
Feb 26, 2026
The Trump administration is proposing new regulations for healthcare plans purchased through Affordable Care Act exchanges that, on the surface, could offer patients lower monthly premiums.
However, the New York Times reported on Thursday that these plans would make up for the lower premiums by charging deductibles as high as $15,000 for individuals and $31,000 for families, meaning that people on these plans would have to pay significant up-front costs should they get sick before getting any benefit from having insurance.
For perspective, the Times noted that these deductibles would be "eight times the average for someone with job-based insurance."
Health experts who spoke with the Times were blunt about these plans' prospects for success.
"Nobody wants that product," Harvard health economist Amitabh Chandra said. "It’s going to be a really cheap product that nobody wants."
Dr. Joseph Betancourt, president of the Commonwealth Fund, told the Times that the plans being mulled by the administration would push greater assumption of risk onto patients and away from insurers.
"There's no doubt that we have an affordability crisis," he said. "As we move forward to shifting more of the burden to patients, there’s a chance to really exacerbate the crisis."
Katherine Hempstead, senior policy adviser for the Robert Wood Johnson Foundation, told the Times that the cheaper Trump plans are "normalizing hardship, and... normalizing catastrophe" by creating a form of health insurance that offers even less coverage than the cheapest plans available on the exchanges.
The high-deductible plans are being pushed by Medicare and Medicaid Administrator Mehmet Oz, who made headlines earlier this year by saying the goal of the Trump administration's healthcare policy was to have Americans be healthy enough so they could stay at work for at least an extra year before retiring.
"If we can get the average person... to work one more year in their whole lifetime, just stay in your workplace for one more year," Oz said during an interview on Fox Business, "that is worth about $3 trillion to the US GDP."
Democratic California Gov. Gavin Newsom, who is widely expected to seek the presidency in 2028, pounced on the report about the high-deductible plans.
"[Trump's] economic agenda is simple," Newsom wrote in a social media post, "force hard working families to pay more and give billionaires a tax break."
Johanna Maska, a former aide to President Barack Obama, expressed disbelief that this was Republicans' long-promised replacement plan for the ACA.
"A $31,000 deductible is unacceptable," she wrote. "This is the Republican long awaited plan? This is not healthcare that helps Americans."
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'Despicable': Vance, Oz Announce Freeze on Some Medicaid Funding for Minnesota
"The Constitution clearly gives Congress the power to spend taxpayer funds, and no law allows the president to halt if he feels some US states aren’t being 'good stewards' of the money," said one critic.
Feb 25, 2026
US Vice President JD Vance said Wednesday that the Trump administration will pause some Medicaid funding for Minnesota over fraud concerns—without offering any guarantees that the suspension will not adversely impact the more than 1 million Minnesotans who depend upon the key healthcare program.
"We're announcing today that we have decided to temporarily halt certain amounts of Medicaid funding that is going to the state of Minnesota in order to ensure that the state of Minnesota takes its obligations seriously to be good stewards of the American people's tax money," Vance said at a White House press conference with Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz.
"Now what is this gonna mean?" Vance continued. "What this means is that, first of all, the providers on the ground in Minnesota have actually already been paid... What we're doing is we are stopping the federal payments that will go to the state government until the state government takes it obligations seriously to stop the fraud that's being perpetrated."
They already targeted SNAP in Minnesota. They’ve killed two Minnesotans and injured or kidnapped hundreds more. Now they’re stealing their Medicaid. They’re going to deny people healthcare because of a YouTube video about a Somali daycare scam that wasn’t even true.
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— Kelly (@broadwaybabyto.bsky.social) February 25, 2026 at 3:05 PM
Oz demanded that Democratic Minnesota Gov. Tim Walz determine "who these providers are; make sure they're not already in trouble for doing bad stuff, and then reevaluate all the current providers to make sure they're supposed to be able to provide these services."
Responding to Oz's remarks, Gaia Leadership Project founder Elizabeth Cronise McLaughlin said on Bluesky, "So Minnesota is supposed to review every appointment by a Medicaid recipient with every doctor to get funds already lawfully allocated to the state?"
Asked by a reporter how he intends to ensure that the funding pause "doesn't impact the people who are enrolled in Medicaid," Vance said he is "worried about the justice of it all."
"I think it's offensive that American taxpayers pay into these programs and they're defrauded... and it's really sad that American children who need these services are unable to get them, because they're going to fraudsters," Vance replied.
"Look, we're certainly gonna make sure that our anti-fraud efforts go after the fraudsters and not after anybody who actually benefits from these services," he continued. "But I actually think the question is a little off, in a way, because the problem is not going after the fraud, the problem is that these programs are being defrauded to begin with."
"Our social safety net will disappear unless we take fraud more seriously," added the vice president, whose boss, President Donald Trump, last year signed into law the biggest cuts to Medicaid and the Supplemental Nutrition Assistance Program, or SNAP, in the nation's history as part of the One Big Beautiful Bill Act.
Medicaid is the primary healthcare safety net for lower-income Americans, with nearly 70 million people enrolled nationwide at the end of last year.
While federal prosecutors are investigating Minnesota’s Medicaid system—specifically, 14 high-risk service programs such as housing support and personal-care services—on suspicion of billions of dollars in fraudulent billings since 2018, and dozens of people have been convicted of stealing public money through the state’s social services system, critics noted that Congress, not the president, has the power of the purse.
Some observers noted that Trump has already targeted Minnesota—which voted against him all three times he ran for president—with his deadly crackdown on undocumented immigrants and their defenders and racist attacks on Somali immigrants, including Congresswoman Ilhan Omar (D-Minn.).
The Medicaid freeze follows the Trump administration's $10 billion cut in federal childcare funding to five Democrat-led states, including Minnesota, last month—a move that opponents argue punishes working families who committed no fraud.
University of Illinois professor Nicholas Grossman called the Medicaid pause "taxation without representation."
"The Constitution clearly gives Congress the power to spend taxpayer funds, and no law allows the president to halt if he feels some US states aren’t being 'good stewards' of the money," he said on Bluesky. "In case there’s any confusion on this, the Impoundment Control Act forbids it."
"The people of Minnesota vote for representatives to Congress," Grossman added. "Minnesota representatives and senators were in DC, representing their constituents, when Congress passed laws using proper procedure that allocated Medicaid funding. The president breaking those laws violates the fundamental compact of the republic."
Oz on Wednesday also announced "a six-month national moratorium blocking all new enrollments for durable medical equipment—prosthesis, orthotics—supplies across the board" in the name of fighting fraud. The move targets suppliers, not individual Medicaid beneficiaries.
This from Oz, a promoter of privatized Medicare Advantage programs, which are notorious for overcharging taxpayers and denying patients necessary care. The CMS under Oz increased federal funding for Medicare Advantage plans by more than $25 billion for 2026.
As Common Dreams recently reported, United Health Group (UHG), one of the country's largest for-profit health insurance companies, has been the leading beneficiary of a long-running Medicare Advantage fraud scheme that the Medicare Payment Advisory Commission—an independent, nonpartisan legislative branch agency—warned could cost US taxpayers $1.2 trillion over the next decade.
Some critics said that if Trump really cared about fraud, he'd go after companies like UHG—and stop pardoning so many convicted criminals who committed billions of dollars worth of fraud.
"These guys are despicable," Michigan State University professor Brendan Cantwell said Wednesday in response to Vance and Oz's announcement.
Robert Weissman, co-president of the consumer advocacy group Public Citizen, said in a statement Wednesday that “Medicaid fraud is a serious problem that requires cracking down on fraudsters—not patients."
Weissman continued:
This administration’s anti-fraud rhetoric is itself a fraud. In fact, the administration has gutted anti-fraud government agencies and programs and let fraudsters off the hook. It has issued record-breaking pardons to fraudsters; sought to eliminate the most important anti-consumer fraud agency, the Consumer Financial Protection Bureau; eviscerated the corps of inspectors general whose job is to root out waste, fraud, and abuses; and dropped dozens of fraud and fraud-related investigations against large corporations.
“The Trump administration suspension of Medicaid funding in Minnesota is a bad-faith, punitive, and shameful measure that will punish people in Minnesota as part of the same deceptive story that the Trump administration has told to justify the outrageous [Immigration and Customs Enforcement] invasion of the state," Weissman added.
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