20 Oct Cancer News You Need: Changes to Medicaid, Paid Leave, Reasonable Accommodations, & More

October 20,2026 ~ This federal and state policy update covers the latest laws, policies, and programs that may affect the cancer community. This month, we share news about Medicaid changes, state paid leave laws, reasonable accommodation protections, and more.

What is Happening in National Health Care News?

Starting September 18, 2026, a new federal public charge rule changes how U.S. Citizenship and Immigration Services (USCIS) decides whether someone who applies for a green card is likely to depend on the government.

• Before, USCIS only looked at cash assistance and long-term care in an institution paid for by the government.
• Now, USCIS can look at nearly any means-tested public benefit (i.e., a benefit based on income) when it decides. This includes Medicaid, SNAP (food stamps), housing assistance, and college financial aid.
• USCIS can also consider other factors, such as age, health, income, family situation, and whether a sponsor’s affidavit of support is strong enough.
• Several states have filed a lawsuit to try to block the rule.

Epic issued a warning about a phishing scam (i.e., a fake message meant to steal personal information) that uses MyChart’s name and logo. Patients may get fake emails and texts that promise a reward, such as a “MyChart Medicare kit.” These messages push people to click a link and share personal or payment information. Patients should not click these links. They should only log in to MyChart through their health system’s official website or app.

What is Happening with Medicaid?

There are major changes to Medicaid being implemented in every state right now. To learn more about those changes, visit TriageCancer.org/HealthInsuranceChanges.

North Carolina’s House Bill 696 will keep Medicaid funded through the rest of the fiscal year, using the state’s contingency reserve. It protects health care coverage for more than 725,000 North Carolinians on Medicaid expansion. But it also makes eligibility rules stricter. State officials now requires individuals to provide more proof that they qualify for Medicaid. When Governor Stein signed the bill, he warned that it could end coverage for nearly 27,000 lawfully present pregnant women and children. He asked lawmakers to fix this gap, but so far, the state legislature has not acted.

The federal government turned down Arkansas’ request to renew ARHOME, its Medicaid expansion program. The program pays for people to buy a Marketplace plan, rather than be covered by Medicaid. This puts coverage at risk for more than 200,000 residents with low incomes. Arkansas has asked for a two-year extension so it can design a replacement program. The state says people will not lose coverage outright, even if the extension is denied. Instead, some people may be moved from Marketplace plans to traditional Medicaid or Medicaid managed care plans. If you are enrolled in ARHOME, you do not need to take any action yet. If your coverage changes, you may qualify for a special enrollment period on the Marketplace or for other help.

About 450,000 New Yorkers lost their Essential Plan health insurance coverage on July 1, 2026. The Essential Plan used to offer free or low-cost health insurance to adults ages 19 to 64 who earned up to 250% of the federal poverty line. Now, because of federal funding cuts and the loss of financial help for many lawfully present immigrants, only people who earn less than 200% of the federal poverty line can qualify. People who lost their coverage can sign up for a Qualified Health Plan through NY State of Health, but their costs will be higher.

What is Happening with Paid Leave and Other Worker Protections?

New Jersey expanded job protection for workers who get Temporary Disability Insurance (TDI) or Family Leave Insurance (FLI) benefits. Starting July 17, 2026, workers who get TDI or FLI benefits have the right to keep their job while they are on leave. This is true even if they do not qualify for another leave law, such as the New Jersey Family Leave Act or the federal Family and Medical Leave Act (FMLA). There is no minimum employer size and no work history requirement. This closes a gap that left workers at small employers, new hires, and part-time or seasonal workers without job protection. When leave ends, employers must return workers to the same job or one with equal pay, benefits, and seniority.

Virginia made two changes to its recently passed paid sick leave law, which takes effect July 1, 2027:

• The definition of “family member” was updated. It now includes an employee’s child, grandchild, grandparent, parent, sibling, spouse, or domestic partner, including step, foster, and adopted relationships. It also includes certain people who live with the employee or depend on the employee for care.
• Employers may require leave to be taken in increments of at least four hours.

New rules for Minnesota’s Earned Sick and Safe Time (ESST) law took effect July 6, 2026. They explain how the law works in a few key areas, including:

• the accrual period (i.e., the time frame for earning sick time), which is the calendar year unless the employer has a clear policy that says otherwise;
• how an employer decides whether a worker will meet the 80-hour minimum to qualify for ESST;
• how to count sick time used during shifts with no set end time;
• limits on how much sick time can be docked from exempt employees for a full sick day; and
• employers’ ability to request documentation of suspected misuse, but not to deny future, legitimate use of leave.

Minneapolis’ Sick and Safe Time Ordinance requires, at minimum, that employees earn sick and safe time at a rate of one hour for every 30 hours worked. In July, the city’s Department of Civil Rights issued Frequently Asked Questions to help employers and employees better understand the ordinance. They cover:

• how time is earned and what the time can be used for; and
• how the ordinance works with other laws, such as Minnesota Paid Leave and the federal Family and Medical Leave Act (FMLA).

Hawaii expanded its Family Leave Law to help military families. Starting July 1, 2026, eligible workers can take family leave for a “qualifying military exigency,” such as arranging childcare while a family member is deployed. Workers can now take leave to help a child, spouse, reciprocal beneficiary, sibling, grandchild, or parent who is serving in the military. Like the rest of Hawaii’s Family Leave Law, this rule only applies to employers with 100 or more employees. Workers must also give reasonable notice before taking leave. They must provide documentation if their employer asks for it.

Washington updated its rules for its paid family and medical leave program, effective October 2, 2026. The updated rules clarify that:

• to qualify to get their job back (i.e., reinstatement), an employee must have worked for 180 days before taking leave, based on their most recent hire date; and
• employees are not eligible for paid family or medical leave benefits if they are serving a waiting period for unemployment.

What is Happening with Reasonable Accommodations?

Minnesota updated its Minnesota Human Rights Act (MHRA) on asking for reasonable accommodations at work, at school, in housing, or from a public facility or service. The law already required businesses, landlords, schools, public entities, and others to work with people with disabilities who need an accommodation, such as a wheelchair ramp or extra time on a test. Beginning August 1, 2026, refusing to take part in the process of working with someone to figure out whether a reasonable accommodation is available, can itself count as an unfair discriminatory practice.

California’s Civil Rights Department (CRD) clarified worker rights under the state’s fair employment law in several key areas:

• Employers with five or more workers must have an ongoing “interactive process,” i.e., a back-and-forth conversation, with any employee who may need an accommodation, such as a modified schedule or remote work, to do their job.
• Accommodation requests do not need to be in writing or use specific legal language.
• Employers can only ask for medical documentation that relates to the request.
• Employers may deny a request only for a genuine hardship.

Beginning October 1, 2026, Connecticut will require employers to give written notice of the right to reasonable accommodations under the Americans with Disabilities Act (ADA). Employers must give this notice:

• at hire, for new employees;
• within 120 days of the law’s effective date, for current employees; and
• within 10 days, for any employee who tells the employer about a disability.

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through events, materials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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