A federal judge on Thursday thwarted the Trump administration from enforcing a rule that would impose a strict version of work requirements for Medicaid recipients battling illness.
U.S. District Judge Richard Stearns in Boston, appointed by former President Bill Clinton, sided with 25 Democrat-led states in their lawsuit against the Trump administration’s rule that critics say would have resulted in chronically ill people being kicked off their insurance coverage.
Medicaid, the jointly federal-state funded health insurance program for low-income and disabled people, covers nearly 66 million adults and nearly 7.2 million children each year.
The Centers for Medicare and Medicaid Services, run by Administrator Dr. Mehmet Oz, issued a rule in June to implement work requirements for Medicaid enrollees that were enacted as part of President Donald Trump’s signature legislation last year, the One Big Beautiful Bill Act.
The law requires adults between the ages of 19 and 64 to complete a minimum of 80 hours per month of community engagement activities, including work, education, or volunteering, to qualify for the program as of Jan. 1, 2027.
The so-called “medically frail” exception for the community engagement requirement written into the law includes people who are blind or disabled, have substance use disorders or disabling mental disorders, have certain disabilities impairing daily activities, or have serious or complex medical conditions.
CMS’s interpretation of the law, as expressed in its June rule, however, required enrollees to show their conditions also “significantly impair” their ability to comply with the work requirements.
Stearns ruled that the CMS definition of medically frail unlawfully limited qualified enrollees because the exemption only applied if someone’s “physical, mental, or other behavioral health condition significantly impairs the individual’s ability to comply with the community engagement requirement.”
“Because enforcement of an unlawful definition of ‘medically frail’ may lead to the disenrollment of otherwise eligible vulnerable individuals relying on Medicaid coverage for continuity of care, the States (and public) face potential for great hardship in the absence of an injunction,” Stearns wrote.
The Washington Examiner contacted CMS for comment.
Stearns held up two other federal restrictions on state verification of medical frailty, including the requirement that states require proof that is less than a year old to substantiate a patient’s medical frailty.
Gov. Josh Shapiro, Democrat of Pennsylvania and the commonwealth’s former attorney general, celebrated the victory on X as part of his reelection campaign ahead of Tuesday’s midterm election vote.
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“Donald Trump and RFK Jr. clearly don’t give a damn about the people who rely on Medicaid to get the care they need — but we do here in Pennsylvania,” Shapiro said. “I’ll continue standing up to protect our most vulnerable Pennsylvanians and make sure they can access the health care they deserve.”
The Democratic attorneys general of California, Massachusetts, and New Jersey led the legal challenge.