Medicaid work rule leaves homeless people in the cold

Tywon Pugh, a 46-year-old man in Missoula, Montana, says new Medicaid work requirements are putting his health at risk. He has seizures that have already cost him a job, and he relies on Medicaid to pay for prescriptions and to access addiction treatment—currently limited by a waitlist. After his wife died last year, he became homeless, and his alcohol-related struggles made seizure management harder. In spring, federal rules require many Medicaid recipients to document work, volunteering, or school to keep coverage, starting checks in states including Montana. Homelessness is not listed as an exemption, and CMS says states must follow the federal list.