Judge blocks Trump administration's Medicaid rule forcing sick recipients to prove frailty
Also reported by PBS NewsHour
Summary
A federal judge blocked a Trump administration rule requiring some chronically ill Medicaid recipients to show that their conditions significantly limit their ability to meet new work requirements before they can qualify as medically frail. The ruling does not overturn the work requirements or two other federal rules on verifying medical frailty.Key Facts
- U.S. District Judge Richard Stearns in Boston issued the ruling on Thursday.
- A coalition of 25 states and the District of Columbia sued over guidance from the Centers for Medicare and Medicaid Services.
- The 2025 law defines medically frail groups to include people who are blind or disabled, have substance use or disabling mental disorders, or have certain serious medical conditions.
- The judge said the states showed that the stricter rule could cause harm through costly changes to their eligibility systems.
- The ruling leaves the Medicaid work requirements in place.
- Stearns upheld rules requiring states to reject medical-frailty diagnoses more than a year old and allowing only one self-attestation during a continuous enrollment period.
- Starting Jan. 1, Medicaid expansion enrollees ages 19 to 64 must document at least 80 monthly hours of work or community service, or attend school at least half time, unless an exception applies.
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