A new national survey from the American Cancer Society Cancer Action Network found that 9 out of 10 cancer patients and survivors were forced to miss work because of their illness.
The findings come as California prepares to implement new federal Medi-Cal work requirements. Under the rules, some adults will have to complete 80 hours a month of qualifying activities to keep their health coverage unless they qualify for an exemption.
Todd Gilmer, a UC San Diego health economist, said meeting the new requirements can get tricky for people with serious health conditions who have difficulty working consistently.
“Part of the challenge is that the guidance has been changing. New rules were released by CMS in June, kind of tightening the eligibility requirements and the work requirements, and kind of clarifying who might qualify due to medical frailty."
Gilmer said before the Centers for Medicare and Medicaid Services (CMS) June guidelines, it was thought that people with active cancers would be exempt from the work requirements.
“But these rules have clarified that even people with active cancers would need to demonstrate that their condition affects their ability to work,” he said.
Gilmer said that could require documentation from a health care provider.
"Currently, the thought is it's going to require a physical kind of examination and attestation by a provider, so it couldn't be a self-assessment,” he said. “They would need to submit some sort of justification or assessment that your ability to work is limited."
In a statement to KPBS, the California Department of Health Care Services said the federal rule introduces "administrative barriers that harms California and will likely cause members, especially those with serious health needs, to lose coverage.”
The agency said the state is fighting the rule in ongoing litigation.
The new requirements are expected to take effect in California in 2027.
Gilmer said people with serious health conditions who rely on Medi-Cal should begin preparing now.
"I would reach out to your insurer, see if you're going to be subject to these requirements, and then start asking them how you can meet them,” he said. “It's in flux, the insurers themselves might not know yet, but it is a place to start."
