25 States and DC Sue Trump Over Medicaid Work Requirement Exemptions

A coalition of 26 jurisdictions filed suit against the Trump administration Tuesday, arguing its new rule defining which Medicaid recipients qualify as medically frail is dangerously narrow and will strip coverage from vulnerable patients.

Twenty-five states and the District of Columbia filed the lawsuit challenging new federal Medicaid work requirement exemption rules.
The plaintiffs argue the administration's definition of 'medically frail' is too restrictive and will cause eligible recipients to lose coverage.
The suit targets a rule that requires most Medicaid recipients to log work hours or lose benefits.
States contend the exemption process places an unworkable burden on chronically ill and disabled enrollees.
The case adds to a growing stack of federal litigation targeting the administration's Medicaid overhaul.

A coalition of 25 states and the District of Columbia sued the Trump administration Tuesday over a federal rule that sets the terms for exempting “medically frail” Medicaid recipients from new work requirements.

The plaintiffs argue the administration's exemption standard is drawn so narrowly that large numbers of chronically ill and disabled enrollees will fail to qualify, triggering coverage losses across millions of low-income households.

The work requirement rule, finalized earlier this year, compels most adult Medicaid recipients to document employment, job training, or community service hours to maintain benefits. Exemptions exist on paper for people deemed medically frail, but the states say the administration's definition of that category is unworkable in practice.

The coalition — led by Democratic-controlled states — filed in federal court and is seeking to block the rule from taking effect while litigation proceeds.

The lawsuit is one of several legal challenges targeting the administration's broader Medicaid restructuring push, which Congressional Budget Office projections have linked to significant future enrollment reductions.

A hearing date has not yet been set. The administration has not commented publicly on the filing.