Key facts
- A federal judge denied a request to block new work requirements for Medicaid recipients.
- The judge cited the provision in the "One Big Beautiful Bill Act" that requires the federal government to cover 90 percent of states’ implementation costs.
- The ruling allows the policy to proceed towards its January 1 implementation deadline.
- The judge denied the injunction request without prejudice, allowing for future reapplication.
- Medical groups have warned the rule will harm physician-patient relationships and patient care.
A federal judge has declined to block a strict work requirement rule for Medicaid recipients, stating that the potential harm cited by plaintiffs did not meet the threshold for an injunction. Judge Richard J. Stearns, appointed by Bill Clinton, ruled late Wednesday that the provision in the "One Big Beautiful Bill Act," which mandates the federal government cover 90 percent of states’ implementation costs, was a significant factor. He also noted that the timeline for implementation was set by Congress, not the Trump administration health officials who were sued.
Stearns denied the states’ request for an injunction without prejudice, meaning they can seek one again if new evidence of harm emerges. He acknowledged that the case involves difficult issues and raises questions about Centers for Medicare and Medicaid Services Administrator Mehmet Oz's adherence to Congressional intent when crafting the stricter medical frailty rule.
The Trump administration, which anticipates the work requirements will reduce Medicaid rolls and save federal funds, is expected to continue defending the policy. This means states must prepare for the January 1 implementation deadline, despite widespread confusion among state officials regarding how to determine who is too sick to work or complete the required 80 hours of monthly community engagement activities.
Some state health departments are informing residents that tens of thousands of individuals who receive insurance through Obamacare’s Medicaid expansion may need to provide a doctor's note to maintain their coverage. This potential burden on physicians has alarmed medical communities. America’s Physician Groups warned the rule is "extremely harmful" and would force physicians to "sit as judge and jury on their [sick Medicaid patients’] ability to work," violating medical ethics. The American Medical Association also supported the injunction request, arguing the rule could undermine physician-patient relationships, interfere with patient care, and increase administrative burdens.