By Nate Raymond
Oct 29 (Reuters) – A federal judge on Thursday blocked US President Donald Trump’s administration from enforcing a rule that would narrow exceptions to new work requirements for Medicaid recipients with serious medical conditions.
US District Judge Richard Stearns in Boston sided with 25 states and the District of Columbia, which argued that the rule would force medically frail people to clear unnecessary hurdles to maintain government-funded health insurance coverage.
The US Centers for Medicare & Medicaid Services, which issued the rule, declined to comment.
Medicaid, the US government health insurance program for low-income Americans, is jointly funded by the federal and state governments.
CMS issued the rule in June to implement work requirements for Medicaid that were enacted as part of Trump’s signature tax and spending measure, the One Big Beautiful Bill Act, which he signed into law last year.
The law requires most adults ages 19 to 64 to perform 80 hours of work or community service each month or be enrolled in an education program at least half time to qualify for Medicaid beginning January 1, 2027.
CMS’s rule provided guidance to states on how to implement the work requirements, including the law’s exemptions for individuals who are “medically frail or otherwise have special medical needs.”
But Stearns said CMS’s rule unlawfully limited who qualifies as “medically frail” by dictating that the exemption only applies 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 judge, an appointee of Democratic former President Bill Clinton, struck down that portion of the rule but upheld two others, including one barring states from relying on proof of patients’ medical frailty that is more than 12 months old.
The decision nonetheless was hailed by the states that challenged the rule. They include California, Massachusetts and New Jersey, whose Democratic state attorneys general led the legal challenge.
“People with serious illnesses or disabilities should not have to worry about losing their healthcare because of work requirements or related barriers,” California Attorney General Rob Bonta said in a statement. “That’s not what Congress intended.”
(Reporting by Nate Raymond in Boston; Editing by David Gregorio)
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