Twenty-five states and the District of Columbia have filed a lawsuit against the Trump administration, challenging its recent guidance on new Medicaid work requirements. The plaintiffs argue that the strict interpretation of these rules by the Centers for Medicare and Medicaid Services (CMS) will create harmful coverage barriers and prevent eligible Americans from accessing necessary healthcare.
The lawsuit alleges that an interim final rule released by CMS oversteps the intent of a law passed last summer that initiated changes to Medicaid. The states contend that the administration's narrow interpretation, particularly regarding medical frailty exemptions, will lead to coverage gaps and administrative chaos as states rush to implement new systems by the January deadline.
Plaintiffs stated that added administrative burdens will cause eligible individuals to lose or be denied coverage, impacting people with disabilities, those undergoing cancer treatment, or individuals with other serious health conditions. They argue these individuals should not be at risk of losing essential care.
According to the lawsuit, the change in the definition of medical frailty came "contrary to months of regular communications with CMS and preliminary guidance materials." States claim CMS has not provided sufficient clarity on how they can update their systems to comply with the new definition, which requires a condition to "significantly impair" an individual's ability to work, volunteer, or attend school for them to be granted an exemption.
Massachusetts Attorney General Andrea Joy Campbell highlighted that the new rule puts thousands of state residents at risk, stating that individuals battling serious health conditions should not face excessive paperwork to access care.