In brief
On Oct. 23, U.S. District Judge Richard Stearns blocked a Trump‑era rule that would have required chronically ill Medicaid beneficiaries to prove that medical conditions ‘significantly impair’ them to qualify for work exemptions. The decision comes after a lawsuit by 25 states and Washington, D.C. The ruling eases the path for some ill people to get exemptions, but the broader work‑requirements framework remains in place.
A U.S. federal judge on Oct. 23 blocked the Trump administration’s Medicaid rule requiring chronically ill beneficiaries to prove medical frailty for work exemptions, a decision that follows a lawsuit by 25 states and Washington, D.C.
Under the rule, people who are blind, disabled, have substance use disorders, or suffer serious medical conditions would have had to demonstrate that their illness significantly impaired their ability to meet work‑ or community‑service hours.
Judge Richard Stearns said the states had shown irreparable harm and that the rule would hamper eligible Americans from getting care and force costly changes to eligibility systems.
The states have met their burden of showing irreparable harm for which monetary damages would provide inadequate compensation – they face the burden of costly and intensive alterations to their eligibility verification systems.
His ruling does not strike down the broader work‑requirement framework that will still be in effect from Jan. 1, 2027, when Medicaid expansion recipients aged 19‑64 must show 80 hours of work, community service, or half‑time schooling.
The Centers for Medicare & Medicaid Services declined to comment. The move means some Medicaid recipients with qualifying medical conditions can now obtain exemptions more easily, while the work requirements remain.
