1. United States
2. Mo.
3. Letter

I am writing about the Medicaid work requirements taking effect under the One Big Beautiful Bill Act. Starting this December, Missouri must begin tracking 80 hours per month of qualifying activity for Medicaid expansion enrollees. Enforcement begins in January 2027. Missouri previously pursued work requirements on its own, so implementation here is likely to move fast. The nonpartisan Congressional Budget Office projects that between 5 and 10 million Americans will lose Medicaid coverage as a result of these requirements. Most of them are already working, in school, or caregiving. They will lose coverage not because they are ineligible, but because they cannot navigate the paperwork. That is not fiscal responsibility. That is bureaucratic disenrollment. I urge you to support legislation that delays implementation until adequate state systems and outreach are in place, and that protects Missourians who meet the underlying eligibility standards from losing coverage due to administrative burden. This is a matter of basic accountability to constituents.