New Legal Battle Against Trump: A Coalition of States Seeks to Block His Medicaid Reform
The lawsuit alleges that the CMS exceeded its authority by issuing an interim final rule that changes the way in which individuals are determined to be eligible for an exemption from the new Medicaid work requirement based on their medical frailty.
Donald Trump in a file photo.
A coalition of 25 states and the District of Columbia filed a lawsuit on Monday against President Donald Trump’s administration to challenge a new federal rule governing which Medicaid beneficiaries qualify for exemptions from upcoming work requirements on grounds of medical frailty. The lawsuit argues that the Centers for Medicare & Medicaid Services (CMS) exceeded its authority by issuing an interim final rule that changes the way in which individuals are determined to be eligible for an exemption from the new Medicaid work requirement based on their medical frailty.
According to the complaint, which was filed in a federal court in Massachusetts, the regulation drastically reduced the work requirement exemptions established by the U.S. Congress for some of Medicaid’s most vulnerable beneficiaries, despite the fact that Congress had previously included various protections for these populations when it passed the legislation. Similarly, the lawsuit contends that the new criteria could cause eligible beneficiaries to lose their Medicaid coverage or be denied it entirely and argues that the rule restricts who can obtain an exemption based on medical frailty and adds unnecessary bureaucratic hurdles to retaining coverage.
The states argue that the Administration’s rule effectively redefines the concept of medical frailty by linking it to a person’s inability to meet the work requirement. According to the lawsuit, state officials had been coordinating implementation plans with CMS for months and were surprised when the agency introduced a much more restrictive interpretation that was not included in the legislation.
Earlier this month, CMS issued guidelines to help 42 states and the District of Columbia implement the Medicaid work requirements established by the One Big Beautiful Bill. Republican lawmakers and officials in the Trump administration have defended this policy as a way to reduce waste, fraud, and abuse within the Medicaid program.
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