Morning Briefing
Summaries of health policy coverage from major news organizations
Judge Blocks Medicaid Work Rule Requiring Sick People To Prove 'Medical Frailty'
AP: Medicaid Rule Forcing Sick Enrollees To Prove Frailty Blocked By Judge
Chronically ill people on Medicaid won’t be bound by new work requirement rules that the latest Trump administration guidance requires in order to qualify for “medically frail” exemptions, a federal judge ruled Thursday. U.S. District Judge Richard Stearns in Boston gave a partial victory to a coalition of 25 states and the District of Columbia, which sued the Trump administration in June over the new Centers for Medicare and Medicaid Services guidance linked to the 2025 law known as the “One Big Beautiful Bill.” (Hussein, 10/29)
On Medicaid for people with disabilities —
NBC News: Ohio Legislators Slam GOP’s Medicaid Fraud Crackdown For Blocking Disabled People From Care
Democratic state legislators are calling on Ohio Gov. Mike DeWine to lift his freeze on new Medicaid providers following an NBC News report revealing that the anti-fraud measure has prevented some disabled people from receiving vital caregiving services. DeWine, a Republican, imposed a six-month moratorium on new Medicaid home-care providers in May, weeks after President Donald Trump signed an executive order declaring fraud “widespread” in public benefits programs. The goal, DeWine’s office said, was to free up state resources to go after alleged fraudsters while protecting Medicaid for the people who need it. (Hixenbaugh, 10/30)
New Hampshire Bulletin: Mixed Reactions Among Disabled Granite Staters On The CFI Lawsuit Settlement
New Hampshire’s Choices for Independence is a state-run Medicaid program that provides in-home care to people with disabilities and older adults. The goal of the program is to allow them to stay in their own home by hiring caregivers and other supports to avoid a nursing home, something that even the state acknowledges would cost roughly three times as much money. After years of severe underinvestment in the program, a coalition of nonprofits sued the state, arguing that by not properly funding the program the state was at risk of illegally institutionalizing people with disabilities. The case, which lasted almost six years and became a class action lawsuit, was set to go to trial next month before both sides came to an agreement to settle the case earlier this month. (Skipworth, 10/29)
More on the high cost of healthcare and prescription drugs —
Fortune, The Conversation: The U.S. Expected 17,000 Disputes A Year When It Passed This Medical Bills Law. It Gets Over 2 Million Instead
Imagine you get hit by a car. An ambulance brings you to the nearest hospital. Your private health insurance covers emergency care, but the hospital isn’t in your plan’s network. (Murtagh, 10/30)
Stat: Patients Report Hidden Billing Traps At Hybrid ER-Urgent Care Centers
It was a simple urinary tract infection. A textbook urgent care visit. Kristin Gills knew the drill. She peed in the cup, and the doctor confirmed her suspicion. He prescribed antibiotics. Before she left Methodist Legacy ER & Urgent Care in Allen, Texas, Gills paid her $211 bill and figured that was the end of it. (Bannow, 10/30)
FOX45 News: Maryland Retiree Drug Costs Lawsuit: Judge Denies Injunction
A federal judge has denied a request to make immediate changes to Maryland’s new prescription drug system for state retirees, but the legal battle is far from over. The decision comes as retirees argue the changes are costing them thousands of dollars and forcing some to dip into their savings to afford medications. (Pryor, 10/29)
Newsweek: Woman Went Hungry To Pay For Father’s Parkinson’s Drugs
A young woman went without food while helping her family pay for her father’s Parkinson’s disease medication, New York City’s health commissioner told the crowd assembled at Newsweek’s AI Health Summit. Dr. Alister Martin said the case showed how financial pressures can become health problems. The city’s health department is now exploring whether artificial intelligence could make it easier for people to apply for benefits such as food assistance. (Tanner, 10/29)
KFF Health News: Medicare Drug Plans Are Hiking Premiums While Trump Claims Victory On Medicine Prices
Millions of Medicare enrollees who buy stand-alone prescription drug plans will see their average monthly premiums rise by 50% in 2027, a new analysis finds. But enrollees can avoid the average increase — from $34 a month to $51 — by switching to lower-cost plans during the program’s open enrollment period, which runs through Dec. 7. (Galewitz, 10/30)
KFF Health News: KFF Health News’ ‘What The Health?’: A New Era For The ACA
Open enrollment for 2027 Affordable Care Act plans begins Nov. 1 in most states, with consumers facing higher out-of-pocket costs and more bureaucratic hurdles. Meanwhile, Democrats in Congress are laying out plans for an aggressive health policy agenda should they win majorities in the House and/or the Senate. With President Donald Trump in office, however, it’s unclear whether any of their legislative efforts could become law in the next two years. (Rovner, 10/29)
