A group of Democratic-led states and local jurisdictions has filed suit against the Trump administration, challenging new Medicaid work requirements that officials say are intended to curb fraud but that opponents argue would illegally limit access to health coverage.
The case, brought by at least 25 states along with the District of Columbia, contends that the Centers for Medicare & Medicaid Services’ newly issued Interim Final Rule (IFR) violates federal law and runs counter to both congressional intent and earlier CMS guidance.
Under the IFR, some Medicaid beneficiaries must submit documentation showing they qualify for an exemption from rules requiring enrollees to work, volunteer or attend school because of serious medical conditions.
Prior to the rule’s release in early June, many highly vulnerable Medicaid recipients were expected to receive automatic exemptions from those requirements. State agencies would have relied on existing medical records to approve exemptions, rather than forcing individuals to file additional paperwork before the requirements take effect in January 2027.
The lawsuit lists Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services (CMS), which issued the IFR, and Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. as defendants.
Oz has previously defended the restrictions, saying such safeguards are necessary to keep the programs from being “defrauded into a turmoil” and arguing that able-bodied people receiving taxpayer-funded benefits should be expected to 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.”
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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.
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.
