Coalition of 25 states sues Trump admin over Medicaid work rule designed to prevent fraud
A coalition of blue states and jurisdictions is suing the Trump administration over new Medicaid work requirements designed to prevent fraud, arguing the policy unlawfully restricts access to health care coverage.
The lawsuit, filed by at least 25 states and the District of Columbia, alleges the newly implemented Interim Final Rule (IFR) — issued by the Centers for Medicare & Medicaid Services (CMS) — violates federal law and departs from Congress' original intent and early CMS guidance.
The IFR requires certain individuals to provide documentation proving they are exempt from Medicaid rules requiring enrollees to work, volunteer or attend school due to severe medical conditions.
Before the rule was issued in early June, highly vulnerable Medicaid recipients were set to be automatically exempt from such requirements. Agencies would have granted those exemptions by reviewing existing health records, without requiring individuals to complete additional paperwork ahead of the requirements taking effect in January 2027.
The lawsuit names Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services (CMS), which issued the IFR, and Robert F. Kennedy Jr., secretary of Health and Human Services (HHS), as defendants.
Oz previously argued that such guardrails are designed to prevent programs from being "defrauded into a turmoil," adding that able-bodied enrollees receiving American tax dollars should contribute to society.
"If you can work, you should get up and work," Oz said.
"If we put guardrails around these programs, we'll allow them to thrive. I'm here because I love Medicaid. The president has already said he loves and cherishes Medicaid and Medicare. … We cannot allow these programs to be defrauded into a turmoil that they cannot pull up from. If we love these programs, we will make the difficult decisions."
The new rule would require able-bodied individuals to work 20 hours a week, volunteer, or pursue education while enrolled in free healthcare coverage.
Fox News reached out to the White House and HHS for comment.
FED AUDIT, EMERGENCY MEDICAID UNDERCUT DEMS ON ILLEGAL IMMIGRANT HEALTH COVERAGE
The plaintiffs involve California, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, New Jersey, New York, Oregon, Rhode Island, Vermont, Washington, Arizona, Colorado, Michigan, Minnesota, Nevada, New Mexico, North Carolina, Pennsylvania, Virginia, Wisconsin and Kentucky.
"People with disabilities, patients in the middle of cancer treatment, or those struggling with another serious or complex health condition, shouldn’t be at risk of losing the care that helps maintain their health," the suit stated.
According to the suit, CMS’s own projections estimate that 2.3 million enrollees will lose Medicaid coverage in the first year alone.
The agency also estimates that 7% of enrollees who are working or qualify for an exemption will lose coverage due to confusing paperwork requirements, strict deadlines or missing documentation, according to the document.
Beginning in 2028, enrollees who do not have immediate medical records on file would be limited to a single opportunity to submit a "self-attestation" form declaring, under penalty of perjury, that they are too sick to work.
Under previous guidance, enrollees were allowed to use self-attestation multiple times as their medical needs evolved.
In addition, plaintiffs said the new rules would force states to abandon automated systems they have already invested in and instead build more complex and costly manual review processes.
As the Aug. 31 deadline to mail notices to Medicaid enrollees approaches, the plaintiffs are seeking a temporary stay and a preliminary injunction to block CMS and HHS from enforcing the rules.