OBBBA work requirements take effect Jan 1, 2027 · Nebraska begins May 2026 · millions will lose coverage
medfrail.com
medicaid · work requirements · exemption

Keep your Medicaid. We generate the proof.

OBBBA's work requirements take effect January 2027. If you have a health condition, disability, or caregiving role, you may qualify for an exemption — but you have to document it. We match you to a licensed physician who reviews your records and issues a defensible medical frailty attestation in 24 hours.

Start my attestation · $99 See how it works
50-state licensed physicians · HIPAA-compliant · 24-hr turnaround · audit-ready PDF
the stakes

Up to 10.1 million people will lose Medicaid by 2028.

Most of them actually qualify for an exemption. They just can't prove it in time. In Arkansas's 2018 experiment, 95% of the people who lost coverage qualified or were working — they failed at the documentation, not the requirement.

62%
health impairs work
Projected coverage loss for people whose self-reported health condition inhibits their ability to work, under low-mitigation state scenarios.
52%
caregiver families
Projected coverage loss for people living with a disabled family member they may serve as caregiver for, under low-mitigation scenarios.
73%
self-employed
Projected coverage loss among self-employed Medicaid enrollees — states cannot automatically verify 1099 income.
Source: Urban Institute / Robert Wood Johnson Foundation · March 2026
the process

Three steps. One physician. Twenty-four hours.

Every attestation is reviewed and signed by a licensed physician matched to your condition.

01

Upload records

Drop in your medical history, diagnoses, medications, and any prior physician letters. Takes five minutes. We handle intake through a secure HIPAA-compliant form.

secure upload · 5 min
02

Physician review

A licensed physician in your state (starting with Dr. Josh Emdur DO, 50-state licensed) reviews your file and — if appropriate — drafts an attestation against the federal OBBBA medical frailty criteria.

physician · ≤ 24 hr
03

Keep your coverage

You receive a signed, timestamped, audit-ready PDF with citation to the specific OBBBA criteria you meet. Submit it to your state Medicaid agency. You keep your coverage.

audit-ready · signed PDF
you may qualify if

Federal law names eight categories that exempt you from work requirements.

Blind or disabled

Any physical, intellectual, or developmental disability that significantly impairs activities of daily living.

Serious or complex medical condition

Chronic illness, cardiac, neurologic, oncologic, autoimmune, or other condition requiring ongoing management.

Substance use disorder

SUD or participation in a drug addiction or alcohol treatment program.

Disabling mental disorder

Depression, anxiety, bipolar, PTSD, schizophrenia, or other psychiatric condition that limits your ability to work.

Caregiver for a disabled family member

You care for a child 13 or younger, or for a person with a disability, in your household.

Pregnant or postpartum

Currently pregnant or entitled to postpartum medical assistance.

Foster care youth

Current foster youth, or former foster youth under age 26.

Veteran with total disability

Veterans with VA total disability rating.

three paths in

Enrollees, health plans, and providers — same attestation engine.

for enrollees

I might lose my Medicaid.

You've heard about the new work requirements and you're worried. Upload your records, we match you to a licensed physician, you get a signed attestation in 24 hours.

$99 · direct pay
Start mine →
for medicaid mcos

My members are at risk.

Every enrollee who churns off costs you capitation revenue. We clear hundreds of frail members through exemption per week — protecting your book without your staff doing the work.

$49–99 · per attestation · volume-tiered
Plan partnership →
for fqhcs + hospitals

My patients need documentation.

Your safety-net patients maintain coverage and you maintain reimbursement. We plug into your EHR, generate attestations for your frail panel, your revenue cycle stays intact.

$49 · per attestation · annual contract
Provider partnership →
the architecture

Built for defensibility. Made to scale.

Public face
medfrail.com — consumer-facing intake, MCO/provider contract portal
this page
Platform
ClinicalSwipe — review marketplace · specialty routing · audit trail · attestation log
infrastructure
Clinical authority
altru.care — Dr. Josh Emdur DO · 50-state licensed · first named attesting physician
supply
Reviewer network
Specialty-matched panel — psychiatry, PMR, addiction medicine, primary care, cardiology
scale
Start my attestation · $99
We are not legal representatives. We generate medical documentation reviewed and signed by licensed physicians. Final eligibility determinations are made by your state Medicaid agency.