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Judge blocks Trump administration’s Medicaid rule forcing sick recipients to prove frailty

The judge said the rule unlawfully narrowed who counts as medically frail and could force eligible Medicaid recipients to lose coverage.

  • On Thursday, U.S. District Judge Richard Stearns blocked the Trump administration from enforcing a rule that narrowed medical exemptions for Medicaid recipients, ruling the guidance was "thus contrary to law."
  • Under the One Big Beautiful Bill Act, Medicaid enrollees aged 19 to 64 must complete 80 hours of work or community engagement monthly beginning January 1, 2027, with exemptions for those considered "medically frail."
  • Stearns determined the CMS rule exceeded congressional intent but upheld other provisions, including a 12-month "lookback" period for medical records and restrictions on self-attestation per continuous enrollment.
  • While the injunction halts the "medically frail" exemption restrictions, the broader work requirements remain in effect; the ruling grants states a six-month period of protection from penalties for implementation errors.
  • Implementation begins January 1, 2027, though eight states have already rejected the grace period, arguing self-attestation opens the door to fraud and will require documentation for benefits.
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OPB broke the news in Portland, United States on Thursday, October 29, 2026.
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