25 States and D.C. Sue Trump Over Medicaid Work Rules for 19-to-64 Expansion Adults
Updated
Updated · The Associated Press · Jun 29
25 States and D.C. Sue Trump Over Medicaid Work Rules for 19-to-64 Expansion Adults
3 articles · Updated · The Associated Press · Jun 29
Summary
Twenty-five states and the District of Columbia sued the Trump administration on Monday, saying CMS's new Medicaid work-rule guidance could wrongly strip eligible people of coverage before a Jan. 1 rollout.
The challenge centers on CMS's tighter definition of medical frailty, which now requires a condition to significantly impair a person's ability to work, volunteer or attend school to qualify for an exemption.
Plaintiff states say that interpretation goes beyond the 2025 law, upends months of implementation planning and leaves them without clear standards for updating systems or verifying exemptions at renewals.
Starting Jan. 1, Medicaid expansion enrollees ages 19 to 64 must document 80 hours a month of work or community service, or attend school at least half-time, unless exempt.
The lawsuit escalates a broader fight over Trump's Medicaid overhaul, which Democrats say will bury cancer patients, disabled people and those recovering from addiction in paperwork and coverage barriers.
Will Medicaid work requirements reduce poverty or worsen the nationwide shortage of essential healthcare workers?
Can technology prevent the administrative hurdles that caused massive coverage losses in past work requirement programs?
With a stricter 'medical frailty' rule, what is the plan to avoid care interruptions for chronically ill patients?
Millions at Risk: States Challenge New Medicaid Work Mandates and Narrowed "Medically Frail" Exemptions
Overview
On June 29, 2026, 25 states and the District of Columbia sued the administration over a new Medicaid rule from CMS that narrows the 'medically frail' exemption for work requirements. The states argue this revised definition is too restrictive and creates major barriers for vulnerable people trying to keep their Medicaid coverage. Their lawsuit also highlights that the rule’s tight timeline—requiring states to notify recipients about these changes by August 31, 2026—is unworkable. Together, these changes risk causing coverage losses for those most in need, prompting states to seek a halt to the rule’s enforcement.