WASHINGTON, June 1, 2026 – Today, the Centers for Medicare & Medicaid Services (CMS) issued a new interim final rule on the implementation of Medicaid work reporting requirements under the One Big Beautiful Bill Act (OBBBA). OBBBA clearly exempts patients with serious illnesses from work reporting requirements. However, this rule goes far beyond the letter and intent of the law by allowing states to impose stringent new requirements on patients with cancer and other serious illnesses that could cause them to lose coverage and jeopardize their health. This rule allows states within months to:
- Narrow the law’s “medical frailty exemption,” subjecting many Medicaid patients with cancer to work reporting requirements.
- Refuse the use of self-attestation for exemptions. This could mean medical providers having to assess patients’ ability to work and submit written assessments to state Medicaid programs—adding significant administrative burdens for both patients and providers.
- Force many patients in treatment to prove they meet or are exempt from work-hour thresholds while also navigating complex new paperwork requirements. That combination will put patients who depend on uninterrupted care to survive at risk of losing coverage.
Statement of Gwen Nichols, M.D., chief medical officer at Blood Cancer United, in response to the new rule:
“As an organization representing thousands of patients who rely on Medicaid for lifesaving care, Blood Cancer United is deeply concerned that this rule will cause many cancer patients to lose their health insurance coverage. Congress promised that no cancer patients would lose their coverage under the One Big Beautiful Bill, and this rule undercuts that promise.
“Cancer is unpredictable—it doesn’t follow a work schedule. Treatment may be grueling and disruptive, making it hard to maintain a steady job. Many patients are in and out of remission. Patients might be in recovery one day and in the hospital the next. Requiring anyone with cancer to work or jump through bureaucratic hoops to keep their health coverage puts lives at risk—full stop.
“The rule would likely impose an unreasonable administrative load on providers, requiring them, in some cases, to determine their patients’ work capacity and submit written assessments. Providers should be focused on patient care, not on paperwork.
“Last year, when we sounded the alarm about OBBBA’s $1 trillion in Medicaid cuts, lawmakers repeatedly assured us that the law they were passing protected cancer patients. But this breaks that commitment, flouts the intent of the law and puts coverage at risk for low-income cancer patients.
“Policymakers at all levels should prioritize policies that expand access to care and support recovery, not create new barriers. We strongly urge CMS to reverse course and honor Congress’s promise to protect cancer patients and others with serious illnesses.”
About Blood Cancer United
Blood Cancer United® (formerly The Leukemia & Lymphoma Society) is the largest global nonprofit focused on blood cancer patient support, research and advocacy. The organization’s mission is to cure blood cancer and improve the quality of life of all patients and their families. To achieve it, Blood Cancer United brings together a community of people—patients and their families, volunteers, healthcare providers, scientists, staff, partners, fundraisers, and philanthropists—who believe all blood cancer patients deserve longer, fuller lives. For support and to learn more, visit www.BloodCancerUnited.org.
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Blood Cancer United Media Contact: Kathy Melley, (617) 791-0708