Comment on CMS-2026-2047-0002

I am writing to comment on the proposed Medicaid community engagement requirements. I support policies that promote employment, community participation, and economic self-sufficiency. However, I am concerned that the proposed rule may unintentionally create barriers for people with disabilities and chronic health conditions who rely on Medicaid. In particular, I am concerned about how the rule defines and administers exemptions related to medical frailty and disability. Many people with disabilities are capable of working, volunteering, participating in education, or engaging in their communities when they have the appropriate supports in place. Policies should not force individuals to identify themselves as "unable to work" in order to maintain access to essential healthcare services. For decades, federal and state disability policies have encouraged Competitive Integrated Employment, community inclusion, and greater independence. Requiring people to demonstrate that they cannot work in order to qualify for an exemption may conflict with these goals and create unintended disincentives to employment. I am also concerned that additional reporting and verification requirements could increase administrative burdens and lead eligible individuals to lose healthcare coverage because of paperwork challenges rather than actual ineligibility. People with disabilities, chronic health conditions, and their families already navigate complex systems and should not face unnecessary barriers to maintaining healthcare coverage.