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We believe that health care coverage should be affordable, accessible, adequate, and understandable.

Patient Organizations Warn of Massive Coverage Losses under Final Work Reporting Requirement Rule

48 non-profit, non-partisan patient organizations issued a statement in response to the interim final rule implementing the new Medicaid work reporting requirement provisions in Public Law 119-21 expressing deep concern that it does not protect people with serious or complex health conditions and would instead dramatically and inappropriately increase the number of people who will lose their healthcare coverage.

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Our members and the people we represent power our work.

In 2017, our patient and consumer advocacy organizations began working together to advance our shared goals and the Partnership to Protect Coverage formed.
 

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PPC advocates for health reforms which meet the following basic elements of meaningful coverage.
 

1: Health Insurance Must be Affordable

Affordable plans ensure patients have equitable access to needed care in a timely manner from an experienced provider without undue financial burden. Affordable coverage includes reasonable premiums and cost sharing (such as deductibles, copays and coinsurance) and limits on out-of-pocket expenses. Adequate financial assistance must be available for people with low incomes and individuals with preexisting conditions should not be subject to increased premium costs based on their disease or health status.
 

2: Health Insurance Must be Accessible

All people, regardless of socioeconomic status, should be able to gain coverage without waiting periods through adequate open and special enrollment periods. Patient protections in current law should be retained, including prohibitions on preexisting condition exclusions, annual and lifetime limits, insurance policy rescissions, gender pricing and excessive premiums for older adults. Children should be allowed to remain on their parents’ health plans until age 26 and coverage through Medicare and Medicaid should not be jeopardized through excessive cost-shifting, funding cuts, or per capita caps or block granting.

 

3: Health Insurance Must be Adequate and Understandable

All plans should be required to cover a full range of needed health benefits with a comprehensive and stable network of providers and plan features. Guaranteed access to and prioritization of preventive services without cost-sharing should be preserved. Information regarding costs and coverage must be available, transparent, and understandable to the consumer in a culturally competent manner prior to purchasing the plan.”


To read our Consensus Healthcare Reform Principles, click here.
Latest Activity
07/31/2026

Comments RE: Medicaid Program; Community Engagement Requirement for Certain Individuals

Comments stating that the Interim Final Rule (IFR) on work reporting requirements goes far beyond the framework established by Congress in Public Law 119-21. The restrictive policies in the IFR – most notably provisions narrowing the definition of medical frailty and eliminating the state option to use sworn attestations – will dramatically worsen outcomes for patients with serious and chronic health conditions while at the same time increasing administrative and financial burdens on patients, health care providers, and states. The comments request that CMS not finalize the harmful provisions of the IFR and instead adopt policies consistent with PL 119-21 and the policy evidence on supporting and improving access to care for individuals living with serious and chronic illnesses.

07/21/2026

Comments RE: Notice of Proposed Rulemaking, Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments

Comments recommending that CMS not finalize the provisions in the SDP NPRM that have no basis in PL 119-21 and would harm individuals living with serious and chronic illnesses.