People with cancer or HIV could lose Medicaid under a new federal work-rule system that advocates say is moving too quickly and could disrupt treatment for millions of low-income Americans.

According to NPR, the policy, issued by the Trump administration, requires states to begin enforcing work requirements by January 1. Meaning patients with serious illnesses may fall through the cracks even when they should qualify for an exemption.

"If you're sitting at home, which is true for the millions of people who are able-bodied on Medicaid, on average, you're spending 6.1 hours watching television, or just hanging around," said Dr. Mehmet Oz, the Administrator for the Center for Medicare and Medicaid Services, to reporters.

The reality TV star-turned White House official went on to say, "As a path to prosperity, Congress very wisely said, 'Let's get you back into the workforce.'"

Health policy experts and medical groups expressed concern over the rule’s narrow language, which could lead to confusion and care being dropped prematurely. That could leave some people with early-stage cancer, HIV, or other chronic conditions at risk of losing coverage if paperwork is incomplete or state systems misread their status.

The changes affect a Medicaid program that covers about 68 million low-income Americans. The rule is part of a broader effort that Republicans say will encourage work and reduce fraud.

​"We're just going to lose people to Medicaid, and then they're going to get sick, and then they're going to die," said Carl Schmid, executive director of the HIV + Hepatitis Policy Institute, to NPR. "So, yeah, I'm upset."

Most adults on Medicaid already work, according to policy researchers cited in the report. But many still do not meet the new 80-hour monthly threshold because of layoffs, unstable schedules, caregiving, school, or other barriers, raising fears that coverage losses will come from red tape rather than job refusal.

Patient advocates say the biggest danger is not just losing insurance, but breaking continuity of care for people who need regular treatment and medication. They warn that even short gaps in coverage could have serious health consequences for patients living with cancer, HIV, and other long-term conditions.