District of Columbia
Federal Judge Rejects Blue-State Lawsuit to Block Upcoming Medicaid Work Requirements
States will have to meet a Jan. 1 deadline to implement new Medicaid work requirements, after a federal judge denied 25 Democratic-led states’ request to pause implementation of the rule. The broad tax and spending law President Donald Trump signed…
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Key points
- A federal judge rejected a challenge from 25 states seeking to pause federal Medicaid work requirements ahead of the Jan. 1 deadline.
- The policy requires adult Medicaid recipients in ACA expansion states to work, volunteer, or attend school for 80 hours per month.
- The court ruled that states failed to demonstrate irreparable harm, noting the federal government reimburses 90% of administrative implementation costs.
NewsWK — A federal judge in Massachusetts has turned back an attempt by 25 Democratic-led states to stall new federal work requirements for Medicaid recipients, keeping a mandatory Jan. 1 implementation deadline on track.
According to a report first published by Stateline, U.S. District Judge Richard Stearns denied a request for a preliminary injunction that sought to halt the rules. The work guidelines were enacted as part of the federal One Big Beautiful Bill Act signed by President Donald Trump last summer.
Work Requirements and Mandates
Under the federal legislation, states that expanded Medicaid under the Affordable Care Act—which includes 42 states and the District of Columbia—must require non-disabled adult beneficiaries to work, attend school, or volunteer for at least 80 hours per month to maintain their publicly funded coverage. Florida remains among the states that chose not to expand Medicaid under the ACA.
The legal action, filed in late June against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), challenged federal administrative guidance that narrowed the definition of who qualifies as “medically frail.” That exemption protects individuals with severe illnesses or serious disabilities from the monthly work obligation.
Court Decision and Taxpayer Reimbursement
State officials bringing the lawsuit argued that the tighter rules would create costly administrative hurdles for state agencies. However, Judge Stearns highlighted in his ruling that the federal government reimburses states for 90% of the design and operational costs tied to executing the requirements.
Stearns emphasized that Congress established the Jan. 1 deadline and concluded that the plaintiffs failed to meet the legal burden necessary to pause a federal policy.
“Because injunctive relief is the exception, not the rule, there is a certain point at which damages fail to justify the issuance of such an extraordinary measure,” Stearns wrote.
The lawsuit was joined by Democratic attorneys general from 25 states along with the governors of Kentucky and Pennsylvania. Projections from the Urban Institute estimate that between 3 million and 7 million recipients nationwide could lose coverage if they do not meet the work verification standards, with potential losses reaching up to 10 million over the next decade as state agencies conduct more frequent eligibility checks.
This article was produced with the assistance of AI and reviewed by our editorial team.
Based on reporting by Nada Hassanein originally published by Stateline. Read the original story.
