Medicaid work rule leaves homeless people in the cold

Key Points:

• Tywon Pugh, a Montana man with seizures and addiction issues, faces potential loss of Medicaid coverage due to new federal work requirements that mandate beneficiaries prove employment, volunteering, or schooling to maintain benefits.
• The federal rules, implemented by the Trump administration and supported by CMS head Mehmet Oz, exempt certain groups but do not consider homelessness a valid exemption, despite Montana and other states wanting to include it.
• Montana plans to enforce these work requirements starting October 2026, risking coverage loss for people like Pugh who struggle with health and housing instability, while Medicaid-funded addiction treatment programs have long waitlists.
• Advocates warn that bureaucratic hurdles and the lack of automatic exemptions for vulnerable populations could lead to many losing coverage, increasing homelessness and health risks, while safety-net clinics may face financial strain.
• Pugh remains hopeful as he awaits addiction treatment and job opportunities, supported by social workers, but his situation highlights the challenges faced by disabled and homeless Medicaid recipients under the new regulations.