A coalition of 25 states and the District of Columbia has filed a lawsuit against the Trump administration over newly implemented Medicaid work requirements, arguing the policy unlawfully restricts access to health care coverage for millions of low-income Americans. The legal challenge, filed in federal court, targets an Interim Final Rule issued by the Centers for Medicare & Medicaid Services (CMS) in early June that requires certain Medicaid enrollees to provide documentation proving they are exempt from work mandates due to severe medical conditions.
The lawsuit names Dr. Mehmet Oz, administrator of CMS, and Robert F. Kennedy Jr., secretary of Health and Human Services (HHS), as defendants. The plaintiffs argue that the rule violates federal law and departs from Congress' original intent, as well as earlier CMS guidance that allowed agencies to automatically exempt highly vulnerable recipients by reviewing existing health records without requiring additional paperwork. Under the new rule, which is set to take effect in January 2027, able-bodied individuals must work at least 20 hours per week, volunteer, or pursue education to maintain their Medicaid coverage.
Dr. Oz has defended the policy, arguing that such guardrails are necessary to prevent fraud and ensure the program's sustainability. «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. … We cannot allow these programs to be defrauded into a turmoil that they cannot pull up from.» The rule is part of a broader effort by the administration to overhaul Medicaid, which includes clamping down on spending and requiring work for able-bodied enrollees.
The states involved in the lawsuit include 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. The plaintiffs contend that the rule will disproportionately harm people with disabilities, patients undergoing cancer treatment, and those with other serious health conditions. «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 lawsuit, 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 percent of enrollees who are working or qualify for an exemption will lose coverage due to confusing paperwork requirements, strict deadlines, or missing documentation. 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.
The plaintiffs also argue that 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 states are seeking a temporary stay and a preliminary injunction to block CMS and HHS from enforcing the rules. The lawsuit highlights the ongoing tension between the administration's efforts to impose work requirements on federal benefit programs and the concerns of states and advocates who warn that such policies could strip health coverage from millions of vulnerable Americans.
The legal challenge is the latest in a series of battles over Medicaid work requirements, which have been a priority for Republican lawmakers and the Trump administration. Proponents argue that work requirements promote self-sufficiency and reduce fraud, while opponents contend that they create unnecessary barriers to health care for low-income individuals, many of whom are already employed or face significant obstacles to work. The outcome of the lawsuit could have far-reaching implications for the future of Medicaid, which provides health coverage to more than 70 million low-income Americans.
