SouthernWorldwide.com – A coalition of 25 states and the District of Columbia has filed a lawsuit against the Trump administration. The lawsuit challenges new work requirements for Medicaid beneficiaries, which the administration claims are designed to prevent fraud.
The plaintiffs argue that the recently implemented Interim Final Rule (IFR) by the Centers for Medicare & Medicaid Services (CMS) unlawfully restricts access to healthcare coverage. They contend that the policy violates federal law and deviates from the original intent of Congress and earlier CMS guidance.
The IFR mandates that certain individuals must provide documentation to prove they are exempt from work, volunteer, or school attendance requirements for Medicaid. These exemptions are for those with severe medical conditions.
Prior to this new rule, highly vulnerable Medicaid recipients were automatically exempted from such requirements. Agencies would have reviewed existing health records to grant these exemptions, without requiring individuals to submit additional paperwork before the requirements took effect in January 2027.
The lawsuit names Dr. Mehmet Oz, the administrator of CMS, and Robert F. Kennedy Jr., the secretary of Health and Human Services (HHS), as defendants. CMS is the agency that issued the IFR.
Dr. Oz has previously stated that these measures are intended to prevent programs from being “defrauded into a turmoil.” He believes that able-bodied enrollees receiving taxpayer money should contribute to society.
“If you can work, you should get up and work,” Oz had stated. He emphasized the importance of implementing these “guardrails” for the programs to thrive.
He further explained, “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.”
The new rule requires able-bodied individuals to work 20 hours a week, volunteer, or pursue education while receiving free healthcare coverage.
The states and jurisdictions involved in the lawsuit are 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. This highlights the core concern of the plaintiffs regarding vulnerable populations.
According to the lawsuit, CMS’s own projections estimate that approximately 2.3 million enrollees could lose their Medicaid coverage in the first year alone under the new rule.
The agency also anticipates that about 7% of enrollees who are working or qualify for an exemption might lose coverage. This is attributed to factors such as confusing paperwork, strict deadlines, or missing documentation.
Starting in 2028, individuals without immediate medical records on file will be limited to a single opportunity to submit a “self-attestation” form. This form would declare, under penalty of perjury, that they are too sick to work.
Under previous guidance, enrollees were permitted to use self-attestation multiple times. This allowed for flexibility as their medical needs evolved over time.
Furthermore, the plaintiffs argue that the new regulations will compel states to dismantle existing automated systems they have already invested in. They would instead need to develop more complex and costly manual review processes.
With the deadline of August 31 approaching for mailing notices to Medicaid enrollees, the plaintiffs are seeking immediate action. They are requesting a temporary stay and a preliminary injunction to prevent CMS and HHS from enforcing these new rules.
