U.S. District Judge Richard Stearns in Boston blocked on Thursday a Trump administration rule that would have required chronically ill Medicaid enrollees to show their conditions “significantly impair” their ability to meet work requirements in order to qualify for the “medically frail” exemption.
A coalition of 25 states and the District of Columbia sued in June over the Centers for Medicare and Medicaid Services guidance tied to the 2025 law known as the “One Big Beautiful Bill.”
In his 16-page ruling, Stearns wrote that the states “have met their burden of showing irreparable harm,” and that enforcing the definition “may lead to the disenrollment of otherwise eligible vulnerable individuals relying on Medicaid coverage.”
BIG NEWS: We just blocked the Trump administration’s attempt to make it harder for many Oregonians to keep Medicaid coverage. https://t.co/HFqWCnn5Nc
— Attorney General Dan Rayfield (@AGDanRayfield) October 29, 2026
Democratic attorneys general framed it as a win against the administration. California Attorney General Rob Bonta said, “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.” He added, “That’s not what Congress intended, and despite the Trump Administration’s cruel attempts to rip away healthcare from those in need, that’s not what the court held today.”
Connecticut Attorney General William Tong said, “This was another web of useless red tape concocted by Trump to deny millions of Americans access to healthcare. We sued and we stopped him, and we’re going to keep fighting to protect access to Medicaid free from arbitrary and cruel bureaucratic barriers.”
VICTORY: A federal court has struck down the Trump administration’s unlawful definition of “medically frail,” which could have forced people with serious illnesses and disabilities to meet Medicaid work requirements or risk losing their health coverage. This ruling will help protect vulnerable Marylanders and ensure that people who qualify for exemptions are not unfairly denied the health coverage they need.
My Office will continue fighting to protect Marylanders’ access to healthcare.
Full press release: https://t.co/UyCVykCSua
— Anthony G. Brown (@OAGMaryland) October 30, 2026
CMS Administrator Dr. Mehmet Oz had said earlier that the guidance would help enrollees “build skills and independence through work, education, job training, or community service,” per the Yahoo/States Newsroom report. That report quoted American Medical Association President Dr. Willie Underwood, who said the ruling “is a victory for patients” and that “Patients should not have to clear unnecessary bureaucratic hurdles to keep their health coverage.”
[NOTE: Judge Stearns left the work requirements themselves in place, and upheld two other federal limits on verifying frailty. States must reject diagnoses more than a year old, and may accept only one self-attestation per continuous enrollment period.]
Starting Jan. 1, 2027, most nonexempt expansion enrollees aged 19 to 64 must work or do community service at least 80 hours a month, or attend school at least half-time. Morgan Henderson, an economist at the Hilltop Institute at the University of Maryland, Baltimore County, said some people “might have their coverage preserved now.”