While this appeals process plays out, people are likely to get sicker and more disabled as they await a final decision. In the end, many people could become stuck in a grey area: too sick or disabled to work, but not sick or disabled enough to be exempt from the work requirement. Barring the possibility that they find an employer sympathetic to his or her special needs, the only way to get out of this in-between space is to eventually become sick or disabled enough that they are eligible for Medicaid. By that time their health care will be much more expensive to the state (if they survive that long).
Such an inherent Catch-22 is remarkably cruel. Getting exempted from the work requirement due to disability will almost certainly require some kind of doctor’s note or documentation. However, if you don’t have insurance, going to the right doctor (or any doctor at all) can be difficult. And as a result, you won’t be able to get the documentation needed to become exempt.
This will be compounded if you don’t have the type of disability that can be easily and quickly diagnosed, such as mental health disabilities or other invisible illnesses. For example, my autoimmune illnesses took years of testing and specialist visits to be diagnosed. If I were reliant on Medicaid in a state with a work requirement, I would have had to pay for years of testing and doctor appointments myself before I finding a doctor willing to sign off on a work exemption. People whose income allows them to be eligible for Medicaid almost certainly cannot afford these upfront costs.
The change in policy will also exacerbate health inequalities that are already a massive national problem. Medicaid is a means-based program, meaning that only low-income people (the income cut-off varies by state) will be affected by these changes. An increase in the access requirements, no matter what those requirements entail, will necessarily reduce the number of people who are able to access Medicaid. Any additional requirements will serve to make people who are currently eligible for Medicaid ineligible. In other words, less low-income people will have access to healthcare so more low-income people will have even worse health outcomes.