On June 29, 2026, governors and attorneys general from 25 states and the District of Columbia filed a lawsuit against the Trump administration regarding new Medicaid work requirements. They argue that the guidance issued by the Centers for Medicare and Medicaid Services (CMS) imposes strict eligibility criteria that could hinder access to care for eligible individuals.
The lawsuit claims that the interim guidance released earlier this month exceeds the provisions of the GOP’s budget reconciliation bill that reformed Medicaid. Starting January 1, 2027, able-bodied Medicaid recipients aged 19 to 64 will be required to demonstrate work, school enrollment, or community service for at least 80 hours per month. Exceptions will be made for those in addiction treatment or deemed medically frail.
The plaintiffs assert that the new definition of “medically frail” is more restrictive than expected, stating that it requires a Medicaid recipient's condition to significantly impair their ability to work or attend school to qualify for an exemption. They contend that the added administrative burdens could lead to eligible individuals losing coverage.
A poll from KFF indicates that about 60% of adults support Medicaid work requirements, including a majority of Republicans and a significant portion of Democrats. However, data shows that nearly two-thirds of Medicaid adults are already employed, with only 8% potentially subject to the new work requirements.
Governor Josh Shapiro of Pennsylvania announced the state's involvement in the lawsuit, expressing concern that the administration's actions could negatively impact those reliant on Medicaid. The Department of Health and Human Services has not commented on the lawsuit.