Montana is about a month and a half away from implementing new requirements for people receiving Medicaid coverage, and some health care advocates are warning about the impacts those changes could have on patients.These are not minor administrative changes, said Denver Henderson, Montana government relations director for the American Cancer Society Cancer Action Network. They're going to have real impacts on people, and they need to be taking that seriously.(Watch the video to hear more about advocates' concerns.) Health care advocates concerned about impacts of Medicaid work requirementsThe federal One Big Bill, passed by Congress last year, requires states to enforce community engagement requirements for most adults on Medicaid expansion, starting Jan. 1, 2027. The Montana Department of Public Health and Human Services has said theyll begin implementing those requirements sooner, on July 1, 2026.As of February, a total of 208,791 Montanans were enrolled in the Medicaid or Healthy Montana Kids programs. Of those, 74,644 were adults on Medicaid expansion.Under the new requirements, most will need to show they spent 80 hours a week working, volunteering, receiving education or doing other approved activities in order to stay eligible for coverage. Some groups are exempted from the requirements, including people 65 and older, pregnant women and parents of children under 13, American Indians and people who are considered medically frail.The Montana Legislature included similar requirements years ago when renewing Medicaid expansion, but the state had never received federal approval to implement them. Supporters have argued the rules will ensure people are incentivized to work, and that the vast majority of recipients are already doing enough to remain eligible.But Henderson says, even if people are in compliance, it may be difficult for them to keep up with the required paperwork. He said many of the people on Medicaid expansion are already struggling to make ends meet and may be working multiple jobs or on a part-time basis.Work requirements don't actually encourage people to work more, he said. They stand in the way for people to be able to keep their health insurance because of those work requirements, because of that red tape.Henderson says about 10% of the population on Medicaid either has a history of cancer or is at risk, and that coverage helps them access screenings and other preventative services.For those who have cancer or are at risk of cancer, having access to health care is the first step to beating it, he said. When you can see a doctor on a regular basis, when you can get your cancer screenings on time, when you can afford your cancer treatments, your chances of surviving and beating cancer are much, much better. When you don't have access to those things, that's when it becomes really a life-and-death matter.Henderson says hes disappointed Montana is implementing work requirements before the federal government is requiring them. He hopes the state will extend the period before they begin actually removing people from coverage.Let's use this period to figure out where there are flaws in the system, and we have time to correct them, he said.DPHHS has set up an online resource for Medicaid members to get answers about the new requirements, and leaders have said theyre reaching out to all members by mail to explain the changes.The department is also currently proposing some amended rules to go along with the community engagement requirements. They are accepting public comment on those proposals through this Friday, May 22. You can find the full rule changes and information on how to submit your comments here. ...read more read less