* The Sun-Times…

The Pritzker administration is alerting more than 700,000 people across Illinois that they will lose, or at risk of losing, their public health insurance due to unprecedented changes from the federal government. […]

The state has mailed letters to people who have Medicaid public health insurance, a state-federal program for those who are low-income or have disabilities. About 3 million people have Medicaid coverage in Illinois, around 1 in 4 people. […]

Next year, about 700,000 people who have joined Medicaid since Illinois expanded eligibility under the Affordable Care Act more than a decade ago are at risk of losing coverage. That’s if they don’t meet work or volunteer requirements. And they will need to prove they are eligible every six months, instead of just once a year. […]

This group is known as “ACA adults.” They are 19 to 64 years old. They don’t have children younger than 18 at home.

These adults must work or volunteer at least 80 hours a month — about four hours a day Monday through Friday — or they could be in school at least part-time, among other criteria. A person could also do a combination of work, volunteer and school to meet requirements, according to the state.

* Related…

* Time | More Americans Are Losing Health Insurance—And Everyone Will Pay: “It’s $2,500 to do a colonoscopy, but it’s $130,000 to treat someone for Stage IV colon cancer,” says Dr. Erik Mikaitis, CEO of Cook County Health, one of the largest public health systems in the nation. Already, Cook County Health—which runs two hospitals and a dozen community health centers in Chicago, while also providing health care to the Cook County Jail—has seen an increase from 19% of patients being uninsured to 25%, just since January. Mikaitis is worried that instead of managing patients’ diabetes and high blood pressure, doctors will be seeing more patients with strokes and heart attacks in the emergency department.

* Capitol News Illinois | Illinois hospitals to lose billions through Medicaid policy change, study finds: Illinois hospitals stand to lose upwards of $4 billion in revenue over the next several years due to impending changes in Medicaid rules that limit states’ ability to direct higher reimbursement payments to facilities that serve the most vulnerable populations. That’s according to a recent study by KFF, a nonpartisan health policy think tank, as well as estimates by the Illinois Health and Hospital Association. And unless Congress acts to reverse those policies before they take full effect, IHA officials warn, roughly half the hospitals in Illinois could be forced to reduce staff, cut back on services or close altogether.

* Capitol News Illinois | 10K Illinois noncitizens to lose Medicaid coverage due to federal changes: “If they are enrolled, then they still have Medicaid up until Oct. 1,” Edith Avila Hesser, ICIRR’s health justice and policy director, said in an interview. “This adds to the number of uninsured populations that we have here in the state of Illinois, and so obviously we will be working to educate this community about the resources that are available to them through community clinics like FQHCs (Federally Qualified Health Centers) and free and charitable clinics available throughout the state.”

* The Daily Tar Heel | Stricter federal guidance complicates Medicaid work requirement rollout in North Carolina: The law includes exemptions for several groups, including pregnant people, certain caregivers, disabled veterans, members of federally recognized tribes and individuals considered “medically frail.” […] Under the new CMS guidelines, state healthcare officials are left to answer questions about what the changed requirements mean in practice, particularly regarding the documentation enrollees will need to verify their eligibility for a medical frailty exemption. “How do we interpret what we thought was medically frail versus medically frail that ‘impairs your ability to comply?’” Sarah Gregosky, assistant secretary and deputy Medicaid director for NCDHHS, said. “Because diagnosis alone may not indicate that there is impairment with their ability to comply.”

* Stat News | Medicaid will let states use ‘tiers’ to determine medical frailty: States aren’t required to use the tier structure, but given the pressure they are under to establish an eligibility-check system by Jan. 1, more flexibility could be helpful. “This data-driven approach could reduce the need for beneficiaries and physicians to submit additional documentation,” the American Medical Association said in a national advocacy update. The group has been calling on CMS to clarify whether diagnostic codes alone could show medical frailty for seriously ill patients. (If not, doctors would’ve had to do more documentation, which many say is unrealistic.)