Checking All the Boxes: A Survey of Medical Frailty Definitions in Alternative Benefit Plans and Section 1115 Work Requirements Demonstrations

Executive Summary

Individuals who are considered medically frail have traditionally been subject to different eligibility and coverage rules in the Medicaid program. Most recently, H.R. 1 exempted medically frail individuals from new work requirement imposed on Medicaid expansion populations. This survey provides information on the use of medical frailty in the past by summarizing medically frail designations in the context of Alternative Benefit Plans (ABPs) and state-level efforts to incorporate work requirements into their Medicaid programs outside of the context of H.R. 1 – specifically, through Section 1115 demonstration programs.