Podcast Extra — Medicaid Changes and Cancer Treatment: What's at Stake?

[00:00:00] Speaker A: Matt I'm Matt McClure with the Retirement Radio Network powered by Amerilife. Well, there are new Medicaid work requirements set to go into effect next year and some experts are warning that that could disrupt cancer treatment and cost patients coverage. Here to talk more about that is Dr. Julie Graylow, Chief medical officer and executive vice president of the association for Clinical Oncology. Dr. Graylow, thanks so much for joining me. Really nice to talk to you again. [00:00:28] Speaker B: Thanks for having me, Matt. [00:00:30] Speaker A: Talk first of all, if you will, about these Medicaid work requirements. As far as I understand it, starting in January of 2027, as I mentioned, that adults ages 19 to 64 are going to be required to work or participate in qualifying community engagement activities at least 80 hours a month to maintain Medicaid coverage. Talk about that and its potential impact. [00:00:57] Speaker B: With the 80 hours a week there are exemptions that you can do and there have been exemptions in place for a while, work exemptions. They're now moving them to not just once a year that you have to prove that you really can't work, but twice a year. So twice as many opportunities for administrative snafus, paperwork, not getting in. But also in addition to just proving that you have a diagnosis that would qualify you like cancer, you have to. The states are obligated to prove back to the federal government again that they're recording why the person can't work. What is the actual issue? Prove that just because they have a cancer diagnosis and they're on chemo, what is it that's preventing them from being able to do this? 80 hours a week of work. Sorry, 80 hours a month of work. And so you can't just self report anymore that you have cancer. You're obligated to demonstrate what it is preventing you from work. And now also new, your health care team has to submit and document and prove that's another burden on the care providers. It's taking away time from caring for patients with cancer. [00:02:15] Speaker A: Wow. Yeah, it sounds like there are just a lot of hoops to jump through. And I mean, that is if I'm understanding. I mean, that is kind of the crux of why it could really negatively impact cancer patients, especially those who are in, as you say, like, you know, active treatment, undergoing chemo, undergoing, you know, maybe radiation or whatever other immunotherapy, whatever other treatments they have to undergo. Just making them and their care teams jump through all these hoops could really have a big negative impact. [00:02:49] Speaker B: We're viewing this as being potentially life threatening for people with cancer. Any Gap in their coverage could result in treatment delays or if they don't delay the treatment out of pocket expenses because they weren't covered during a chemo cycle, that could result in worse survival outcomes. You know, and not because they aren't eligible for this waiver, this exemption for the work requirements, but because the paperwork hasn't been processed correctly. [00:03:22] Speaker A: Yeah. And right. As you were saying, there's there even just administrative errors and all of this can lead to folks losing their coverage, even just temporarily, let's say someone even, even if it just is for a short period of time, however long that might be, what kind of an impact could that have when a Medicaid covered individual loses that coverage, even just for a temporary time period? [00:03:49] Speaker B: Well, if they know they've lost the coverage, they're going to delay their treatment. They're not going to maybe pick up their next prescription. And that right there, those gaps can really impact the curability of the cancer. We know that Medicaid covers about 1 in 5 adults under the age of 65 who are newly diagnosed with cancer. And also Medicaid covers about 2 million individuals who have a history of a diagnosis of cancer. This is a lot of Americans. [00:04:22] Speaker A: Yeah. It's not something that's just a very isolated thing. I think people maybe in the general population who are not impacted or covered by Medicaid might think that, oh, well, this is just, you know, how many people could it possibly affect effect? And as you say, there, you know, millions. Are there ways to rectify this and make this situation not as burdensome and potentially, as you say, life threatening for these patients? [00:04:51] Speaker B: Well, our recommendation is to encourage states, and each state is going to implement this differently, but to encourage states to accept what's already in the electronic medical record, the billing that's already going to Medicaid that proves the diagnosis and what treatment patients are on. Don't make us reinvent the wheel. Fill out paperwork, fax things, whatever the requirements could be. Just accept that in the medical record. We already have documentation of a diagnosis of cancer. We already know and we're billing for the treatment. Accept that as proof both on behalf of the patient and on behalf of the care providers that you know, this is already known. And don't force additional paperwork, additional time and expenses, things that could get lost in the mail or just because a patient is so tired they forgot to submit something on time. [00:05:55] Speaker A: Now, just about time for us to wrap things up here, Dr. Graylow. But if folks who are listening want to learn more about this issue and about how they can potentially make a difference here. Where could they go to find out more information? [00:06:12] Speaker B: Our website has some additional information. It's ASCO.org Medicaid that's a S C O. O R G Medicaid. And again, I'll reemphasize this is a state by state issue, how each state is going to implement it. It's now at the state level. The guidance comes from the federal government but the states will decide how they're going to implement it. So also look at what your own state is doing. We have some of that information on our website and contact your lawmakers. [00:06:43] Speaker A: Very good. Well, Dr. Julie Graylow is chief medical officer and executive vice president of the association for clinical oncology or ASCO. Dr. Graylo, thank you so much for taking some time for me and talking about this really important topic. Really appreciate it. [00:06:57] Speaker B: And thanks for spreading the word with [00:06:59] Speaker A: the retirement radio network powered by AmericanLife. I'm Matt McClure.