Blue States Sue Trump Administration Over Medicaid Work Requirement
A group of predominantly Democratic states is taking legal action against the Trump administration regarding a new Medicaid work requirement aimed at reducing fraud. They argue this policy illegally limits access to health insurance.
The lawsuit, which includes at least 25 states and the District of Columbia, claims the Interim Final Rule (IFR) issued by the Centers for Medicare and Medicaid Services (CMS) contradicts federal law and strays from Congress’ original intentions, as well as earlier CMS guidelines.
This IFR mandates that certain individuals must provide proof they are exempt from work, volunteer, or educational requirements when they have severe medical issues. Before this rule was introduced in June, vulnerable Medicaid recipients were to be automatically exempt without needing to submit extra documentation. CMS would rely on existing health records instead.
The suit names Dr. Mehmet Oz, the CMS administrator behind the IFR, and Robert F. Kennedy Jr., Secretary of the Department of Health and Human Services (HHS), as defendants.
Oz has previously asserted that these regulations are essential to prevent the program from becoming chaotic and emphasized the importance of able-bodied recipients contributing to society. “If you can work, get up and go to work,” he stated, adding that careful oversight is vital for the program’s success. “We can’t let these programs get caught in a mess.”
According to the new guidelines, able-bodied individuals will need to work at least 20 hours a week, volunteer, or pursue education while receiving free healthcare.
The plaintiffs include states like California, New York, and Massachusetts, among others. The complaint argues that individuals with disabilities or serious health problems should not risk losing critical care.
Estimates from CMS suggest about 2.3 million enrollees could lose their Medicaid coverage in the first year post-implementation. Moreover, roughly 7% of those already working or eligible for exemptions may also find themselves without coverage due to complicated documentation processes.
Starting in 2028, enrollees failing to keep updated medical records will only have one chance to declare their inability to work, under penalty of perjury. Previously, individuals could self-certify multiple times as their conditions evolved.
The plaintiffs argue these new regulations force states to abandon their automated systems, which they have already invested in, and shift to more cumbersome and expensive manual reviews.
As the August 31 deadline looms for notifying Medicaid recipients, the lawsuit is pushing for a temporary halt and preliminary injunction to stop CMS and HHS from enforcing the new rule.
