Blue states sue Trump admin over Medicaid work requirements

Democrat administrations in 25 states and the District of Columbia on Monday filed a lawsuit against the Trump administration over its recent guidance on new Medicaid work requirements, arguing that strict eligibility requirements will prevent eligible Americans from accessing care.

The governors and attorneys general who filed the lawsuit allege that an interim released earlier this month from the Centers for Medicare and Medicaid Services oversteps the text of the GOP’s budget reconciliation bill passed last year that overhauled Medicaid. 

Medicaid, a federal-state joint program, provides health insurance coverage for low-income adults, pregnant women, and children, covering roughly 72 million adults and an additional 7.3 million minors. 

Starting on Jan. 1, 2027, able-bodied Medicaid enrollees ages 19 to 64 will have to show that they work, are in school, or do community service at least 80 hours per month, equivalent to a part-time job. There are also exceptions carved into the legislation for those in addiction treatment or who are qualified as “medically frail.”

The plaintiffs in the lawsuit say CMS Administrator Dr. Mehmet Oz and his team threw states a curveball earlier this month by issuing a narrower definition of “medically frail” than they anticipated.

The CMS guidance says that a Medicaid recipient’s condition must “significantly impair” their ability to work, volunteer, or attend school to require an exemption, which is more stringent than prior draft iterations of the guidance. 

The attorneys general and governors argue that the “added administrative burdens will cause individuals who are eligible for Medicaid to lose or be denied coverage.” 

“People with disabilities, patients in the middle of cancer treatment, or those struggling with another serious or complex health condition, shouldn’t be at risk of losing the care that helps maintain their health,” wrote the plaintiffs.

Roughly 6 in 10 adults support the idea of Medicaid work requirements, according to a poll conducted last year by the health policy group KFF. That included nearly eight in 10 Republicans and five in 10 Democrats. 

But nearly two-thirds of Medicaid adults are already employed either full-time or part-time, according to KFF. Another 12% are not working due to caring for dependents, 10% due to illness or disability, and 7% due to school attendance. 

That leaves only 8% of Medicaid adults between the ages of 18 and 64 who would be subject to work requirements. 

BREAKING: We just sued the Trump Administration for trying to rip away Medicaid from Pennsylvanians who need it most.

Donald Trump, Dr. Oz, and RFK Jr. are hellbent on trying to push aside people who rely on Medicaid to get the care they need.

But here in Pennsylvania, we’re…

Gov. Josh Shapiro (D-PA) announced his state’s involvement in the lawsuit on X by saying that the administration is “trying to rip away Medicaid from Pennsylvanians who need it most.”

“Donald Trump, Dr. Oz, and [Health and Human Services Secretary Robert F. Kennedy Jr.] are hellbent on trying to push aside people who rely on Medicaid to get the care they need,” Shapiro said. “But here in Pennsylvania, we’re going to keep standing up to protect our most vulnerable Pennsylvanians.” 

Shapiro is in the midst of a reelection campaign for governor. He, along with Gov. Andy Beshear (D-KY), who also joined the suit, is a contender for the 2028 Democratic presidential nomination.

HHS did not respond to the Washington Examiner’s request for comment on the legal challenge.