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Medicaid Ruling Removes an Extra Hurdle for Seriously Ill Enrollees—but Work Requirements Still Begin in 2027
The ruling blocks a CMS requirement that would have forced medically frail enrollees to prove their conditions also limit work ability.
- On Thursday, U.S. District Judge Richard Stearns ruled that the Centers for Medicare and Medicaid Services overstepped the law by imposing a "significantly impairs" test for medically frail Medicaid enrollees seeking work-requirement exemptions.
- The 2025 One Big Beautiful Bill Act exempts medically frail individuals from work requirements, yet CMS issued an interim rule in June adding a second hurdle requiring proof of significant impairment to qualify for that exemption.
- Stearns sided with 25 states and the District of Columbia, ruling the test "is beyond the powers of CMS and thus contrary to law" because it could lead to disenrollment of otherwise eligible vulnerable individuals.
- American Medical Association President Dr. Willie Underwood III called the ruling "a victory for patients," while Stearns granted a six-month stay on federal enforcement of medical frailty determinations, allowing states to revise eligibility systems.
- Despite this partial victory, the 80-hour monthly work requirement for most adults ages 19 to 64 remains scheduled to take effect in most states on January 1, 2027, as the court upheld other administrative limitations on frailty documentation.
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‘Medically frail’ Medicaid enrollees won’t have to prove inability to work to keep care
Medicaid recipients who are disabled or have a chronic illness will not have to prove they are unable to work to be exempted from new work requirements that take effect next year, a federal judge ruled. But the ruling upheld other restrictions on coverage.
·Annapolis, United States
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Ohio Capital Journal+4 Reposted by 4 other sources
‘Medically frail’ Medicaid enrollees won’t have to prove their inability to work to keep coverage
Medicaid recipients who are disabled or have a chronic illness will not have to prove they are unable to work to be exempted from new work requirements that take effect next year, a federal judge ruled Thursday. The decision by U.S. District Judge Richard Stearns in Boston grants a partial victory to the 25 Democratic-led […]
Coverage Details
Total News Sources13
Leaning Left9Leaning Right0Center2Last UpdatedBias Distribution82% Left
Bias Distribution
- 82% of the sources lean Left
82% Left
L 82%
C 18%
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