This bill repeals recent changes to Medicaid eligibility redetermination procedures, restoring prior law.
Rick Larsen
Representative
WA-2
The Patients Over Paperwork Act of 2025 aims to streamline healthcare by repealing recent changes to Medicaid eligibility redeterminations. This action effectively restores prior regulations concerning how beneficiaries' eligibility is reviewed. The bill focuses on reducing administrative burdens to prioritize patient care.
Medicaid Redetermination Rules Rolled Back: 'Patients Over Paperwork Act' Aims to Stabilize Coverage
The newly introduced Patients Over Paperwork Act of 2025 is short, sweet, and focused on one critical thing: making sure people who need Medicaid don’t lose it because of bureaucratic hurdles. This bill specifically repeals Section 71107 of Public Law 11921. If that sounds like alphabet soup, here’s the translation: it’s hitting the rewind button on recent changes to how states re-check (or 'redetermine') if you still qualify for Medicaid.
Hitting the Rewind Button on Eligibility Checks
Think of Medicaid redetermination like renewing your driver's license—it’s necessary, but if the process is overly complicated or the paperwork is confusing, you can accidentally lose access to something vital. The previous law (Public Law 11921) changed those rules, and this new bill effectively treats those changes “as if they never happened” (SEC. 2). This means we revert to the older, established rules for checking eligibility.
Why does this matter? For the millions of people who rely on Medicaid, especially families with kids, seniors, or people with chronic conditions, maintaining continuous coverage is essential. When eligibility redetermination rules become too strict or complex, people who are still qualified often lose coverage simply because they missed a confusing form or couldn't navigate the system—a phenomenon often called “churn.”
What This Means for Real People
Imagine a single parent working two jobs whose child has asthma. Under recent changes, if that parent missed a piece of mail or couldn't get time off work to submit a specific document during a narrow window, the child’s essential health coverage could be cut off. By repealing the change, this Act aims to stabilize the process and reduce the likelihood of these coverage losses. It’s about reducing the administrative burden on the beneficiary—the patient—and prioritizing their ongoing care.
While this is a clear win for beneficiaries, there is a flip side to consider for the state agencies and contractors who manage the system. They spent time and resources implementing the rules from Public Law 11921. Now, they have to pivot back to the older procedures. If the repealed law was meant to introduce administrative efficiencies, those potential gains are now off the table. However, the clear goal here is to trade potential administrative streamlining for greater stability and accessibility for the people actually receiving care.