A U.S. federal judge on Thursday blocked a Trump administration policy that would have forced chronically ill Medicaid recipients to prove medical frailty to qualify for work‑exemption relief. U.S. District Judge Richard Stearns ruled that the rule overstepped federal authority and would unfairly restrict legal exemptions for people with serious illnesses, siding with a lawsuit brought by 25 states and the District of Columbia.
Al Jazeera reported that the judge’s decision eases the path for some chronically ill individuals to obtain exemptions, though it leaves the Medicaid work‑requirement framework largely intact. The rule, which the Centers for Medicare & Medicaid Services adopted in July, would have mandated that beneficiaries not only meet a “medically frail” definition but also demonstrate that their conditions “significantly impair” their ability to comply with work requirements.
"The states have met their burden of showing irreparable harm for which monetary damages would provide inadequate compensation – they face the burden of costly and intensive alterations to their eligibility verification systems," Judge Stearns said in his 16‑page ruling.
ABC News noted that the ruling means chronically ill people on Medicaid will not be bound by the new work‑requirement rules, which take effect on Jan. 1, 2027 for Medicaid expansion enrollees aged 19 to 64. Those beneficiaries will still need to work or provide community service 80 hours a month, or be enrolled in school, unless they qualify for an exemption. STAT News echoed the decision, saying CMS exceeded its authority by narrowing the scope of medically frail exemptions.
While the judge’s order stops the enforcement of the stricter rule, it does not strike down the overall work‑requirement program. States that appealed to the Supreme Court are awaiting a ruling that could reshape how Medicaid work requirements are applied nationwide.
