A coalition of 25 states and the District of Columbia has filed a lawsuit against the Trump administration regarding new Medicaid work requirements aimed at preventing fraud. The lawsuit claims that the Interim Final Rule (IFR), issued by the Centers for Medicare & Medicaid Services (CMS), unlawfully restricts access to healthcare coverage and violates federal law.
The IFR mandates that certain individuals must provide documentation to prove they are exempt from Medicaid work requirements due to severe medical conditions. Prior to the rule's implementation in June, vulnerable Medicaid recipients were automatically exempt from these requirements based on existing health records, without needing to submit additional paperwork before the rules take effect in January 2027.
The lawsuit names Dr. Mehmet Oz, the CMS administrator, and Robert F. Kennedy Jr., the Secretary of Health and Human Services, as defendants. Dr. Oz has stated that the new requirements are intended to prevent fraud and ensure that able-bodied enrollees contribute to society.
The new rule requires able-bodied individuals to work 20 hours per week, volunteer, or pursue education while enrolled in Medicaid. The lawsuit argues that the CMS's projections indicate that 2.3 million enrollees could lose Medicaid coverage in the first year due to the new requirements. Additionally, 7% of enrollees who are working or qualify for an exemption may lose coverage due to complex paperwork requirements.
The plaintiffs are seeking a temporary stay and a preliminary injunction to prevent the enforcement of these rules as the deadline for notifying Medicaid enrollees approaches.