A federal judge has blocked a Trump administration rule that would have required chronically ill Americans, including cancer patients, to give additional proof they are unable to work in order to receive Medicaid.
Judge Richard Stearns of the U.S. District Court for Massachusetts sided with a coalition of Democratic states that called the Trump administration’s definition of “medically frail” — a category that is exempted from Republicans’ new Medicaid work requirements — too onerous.
Enforcement of “an unlawful definition of ‘medically frail’ may lead to the disenrollment of otherwise eligible vulnerable individuals relying on Medicaid coverage,” the judge ruled. He added that states and the public could face “potential for great hardship.”
Stearns also noted the tight timeline in which states were working to implement work requirements and said they should receive a six-month extension to determine if an individual qualifies as medically frail. The judge left the rest of the Trump administration’s rules around Medicaid work requirements in place.
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The Centers for Medicare and Medicaid Services, or CMS, didn’t immediately respond to a request for comment.
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Republicans established Medicaid work requirements under their sweeping domestic policy and tax law, which President Donald Trump signed last year. The policy requires adults covered under the program’s expansion to complete a minimum of 80 hours of work or community-engagement activities per month or be enrolled in education part-time to qualify for Medicaid.
The new requirements are expected to impact about 18.5 million of Medicaid’s 66 million enrollees. States have been preparing to enforce the new requirements, which go into effect in January.
Patient advocates were concerned after CMS spelled out how the medical-frailty exemption would work in a rule issued in June. The rule said a condition must “significantly impair” someone’s ability to work and eventually would require confirmation from a doctor.
CMS’s original wording could have made it more difficult for people who are not considered disabled but have debilitating conditions, such as cancer or sickle-cell disease, to qualify for Medicaid coverage.
“Today’s decision is a major victory that ensures that some of our most vulnerable residents are able to continue to access the healthcare they deserve,” California Attorney General Rob Bonta said. “People with serious illnesses or disabilities should not have to worry about losing their healthcare because of work requirements or related barriers.”
When Republicans passed the Medicaid work requirements, Trump administration officials said they were seeking to minimize enrollee paperwork and ensure that those eligible for a work exemption received it while minimizing fraud.
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