A coalition of 25 states and the District of Columbia has filed a lawsuit against the Trump administration over newly implemented Medicaid work requirements, alleging the policy unlawfully restricts health care access.
The lawsuit targets the Interim Final Rule issued by the Centers for Medicare and Medicaid Services, which plaintiffs argue violates federal law and departs from Congress’ original intent.
The rule requires certain individuals to submit documentation proving they qualify for an exemption from Medicaid requirements mandating that enrollees work, volunteer, or attend school due to severe medical conditions.
Prior to the rule’s issuance in early June, highly vulnerable Medicaid recipients were set to receive automatic exemptions based on existing health records, with no additional paperwork required.
The lawsuit names Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, and Robert F. Kennedy Jr., secretary of Health and Human Services, as defendants.
Oz has publicly defended the requirements, arguing that safeguards are necessary to prevent programs from being “defrauded into a turmoil” and that able-bodied recipients of taxpayer-funded coverage should contribute to society.
“If you can work, you should get up and work,” Oz said, adding that “if we put guardrails around these programs, we’ll allow them to thrive.”
According to the suit, CMS’s own projections estimate that 2.3 million enrollees will lose Medicaid coverage in the first year alone under the new framework.
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.
The suit states that “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.”
Beginning in 2028, enrollees without 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 permitted to use self-attestation multiple times as their medical needs changed over time.
Plaintiffs also argue the new rules would force states to dismantle automated systems already built and replace them with more complex and costly manual review processes.
The coalition of plaintiffs includes California, New York, Illinois, Michigan, Pennsylvania, Colorado, Virginia, North Carolina, Wisconsin, Kentucky, and more than a dozen other states.
With an August 31 deadline approaching for mailing notices to Medicaid enrollees, the plaintiffs are seeking both a temporary stay and a preliminary injunction to block CMS and HHS from enforcing the rules.
