Rheumatology Organizations Call for Protections in Medicaid Work Requirements

The American College of Rheumatology, Arthritis Foundation, Coalition of State Rheumatology Organizations, and the North Carolina Rheumatology Association highlight the need for Medicaid work requirement policies that reflect chronic, fluctuating conditions and protect continuity of care.

ATLANTA – The American College of Rheumatology (ACR), Arthritis Foundation, Coalition of State Rheumatology Organizations (CSRO), and the North Carolina Rheumatology Association (NCRA) are closely monitoring legislation advancing in the North Carolina General Assembly that would implement work reporting requirements into the state’s Medicaid funding bill. As mandated by the One Big Beautiful Bill Act (OBBBA), signed in July 2025, this policy could set a far-reaching precedent for how states nationwide determine access to coverage.

For people living with arthritis, Medicaid coverage can be essential to maintaining mobility, managing chronic pain, and preventing irreversible joint damage. Consistent access to medications, specialists, and ongoing treatment helps slow disease progression and supports long-term physical function and independence.

“For patients with rheumatic diseases, stable access to care is not optional, it’s essential,” said William F. Harvey, MD, MSc, FACR, president of the American College of Rheumatology. “Work reporting requirements that do not account for fluctuating disease activity risk disrupting treatment and jeopardizing patients’ ability to remain functional and independent.”

“The Arthritis Foundation, the ACR, CSRO and NCRA believe that Medicaid work reporting requirement policies must be carefully designed to avoid penalizing patients for circumstances beyond their control,” said Steve Taylor, President and CEO of the Arthritis Foundation. “Medical frailty definitions should reflect the lived experience of chronic conditions like arthritis, recognizing that functional ability can vary over time. Work reporting requirements should not result in inappropriate coverage loss for individuals with chronic disease.”

“Patients with debilitating chronic conditions can often face challenges and maintaining consistent work due to their conditions. We urge the North Carolina legislature to recognize the need to incorporate exemptions into the budget to ensure that these patients receive the necessary care and coverage that they need through the same Medicaid program,” stated Firas Kassab, MD, of the North Carolina Rheumatology Association.

“Patients with chronic health conditions who do not have adequate health insurance coverage will continue to face challenges in securing regular employment,” stated Madelaine Feldman, MD of the Coalition of State Rheumatology Organizations. “It’s important for the state to adopt policies that support patients as they work to manage their condition, minimize flair ups and live productive lives.”

As North Carolina lawmakers consider next steps, implementation must prioritize continuous coverage, simplified and accessible reporting processes, and strong protections for people with disabilities and chronic conditions.

We stand with our partners in emphasizing the importance of protecting access to care and will continue to advocate for policies that ensure people with arthritis can maintain their health, independence, and quality of life.

“We will continue working alongside our partners to ensure Medicaid policies center patients, protect access, and avoid disruptions, so people living with arthritis can maintain consistent care,” Taylor affirmed.

“The ACR looks forward to working with policy leaders, in North Carolina and across the country, to ensure these policies do not create unintended barriers to care for patients with complex, lifelong conditions,” Harvey concluded.

Media Contact
Teri Arnold
Director, Public Relations & Communications
757-272-7002
tarnold@rheumatology.org

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About the American College of Rheumatology
Founded in 1934, the American College of Rheumatology (ACR) is a not-for-profit, professional association committed to advancing the specialty of rheumatology that serves nearly 10,500 physicians, health professionals, researchers and scientists worldwide. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatology professionals are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases.

About the Arthritis Foundation
The Arthritis Foundation is the leading nonprofit organization dedicated to the fight against arthritis — the nation’s #1 cause of disability. Through groundbreaking scientific research, patient-centered programs, advocacy at all levels of government and robust community engagement, the Foundation empowers people to live their best lives while relentlessly pursuing a cure. With a presence in communities nationwide, we amplify the voices of those affected and work to drive lasting change. Learn more at arthritis.org.