Taya Hailstone, a 19-year-old cancer survivor in remission from Hodgkin lymphoma for five years, faced the loss of her low-cost Medicaid disability coverage last year when Montana’s health department determined she no longer qualified. The state transferred her to the Children’s Health Insurance Program, another Medicaid program, just three months before she would have aged out of pediatric coverage.
Hailstone had discontinued her Social Security disability payments in hopes of improving her health and building savings beyond the strict income limits attached to those benefits. However, the lingering effects of her childhood cancer diagnosis—including partial intestine removal, severe dehydration risks, cognitive fog, and physical limitations—continue to make consistent work difficult. She underwent cancer treatment beginning at age 10 and requires approximately three medical appointments weekly with specialists in a town located two hours from the nearest major medical center. The state made its decision without reviewing medical records from her treatment team, according to correspondence reviewed by KFF Health News.
Hailstone’s case reflects broader concerns about states’ readiness to implement new federal Medicaid work requirements that take effect in January 2027. The Congressional Budget Office estimates 18.5 million people will need to prove they are working, studying, or volunteering to maintain coverage, with exemptions available for those deemed “medically frail” or too sick to work. More than 5 million people are projected to lose Medicaid coverage by 2034 due to these requirements.
Advocates and legal experts argue states lack adequate resources and infrastructure to fairly assess complex disability cases. The federal government allocated $200 million for implementation across all states, while the Social Security Administration spends more than $5 billion annually reviewing roughly 7 million disability cases. In June, 25 states sued the Trump administration over the medical frailty assessment rules, contending the standards are too stringent for patients to meet and for states to evaluate. Montana began implementing work requirements in July, among the earliest states to do so. Hailstone and her mother have continued to receive Medicaid coverage pending their appeal.
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