Judge Blocks Part Of Medicaid Work Requirement Rule

Federal Judge Blocks Part of Trump Administration’s Medicaid Work Requirement Rule

A Boston judge blocked a CMS requirement that medically frail people show their condition also 'significantly impairs' their ability to work. He upheld two other provisions and did not strike down the work requirements.

Facts

U.S. District Judge Richard Stearns in Boston on Thursday, October 29, 2026, blocked part of a Trump administration rule on Medicaid work requirements, in a 16-page ruling the Associated Press described as a partial victory for the plaintiffs. PBS NewsHour carried the report.
A coalition of 25 states and the District of Columbia sued in June over new guidance from the Centers for Medicare and Medicaid Services (CMS). The guidance implements the 2025 law known as the ‘One Big Beautiful Bill.’
The law defines ‘medically frail’ to include people who are blind or disabled, have substance use disorders or disabling mental disorders, have certain significantly impairing disabilities, or have serious or complex medical conditions. The CMS rule went further, requiring people in those categories to show that their conditions also ‘significantly impair’ their ability to comply with work requirements. Stearns blocked that added requirement.
He upheld a rule requiring states to reject proof of frailty if the diagnosis is more than a year old. He also upheld a policy allowing only one self-attestation per continuous enrollment period. The work requirements themselves were not ruled unlawful.
Starting January 1, Medicaid expansion enrollees aged 19 to 64 must work or do community service at least 80 hours a month, or be in school at least half time. Exceptions exist for medically frail people and those in addiction treatment programs, among others.
The AP reported that the plaintiffs argued the stricter rule would keep eligible Americans from getting needed care and went beyond the law’s text. HHS and CMS did not immediately respond to the AP’s request for comment, so no administration statement was included in the report.

Quotes

Judge Richard Stearns, finding the states had shown irreparable harm, wrote that “they face the burden of costly and intensive alterations to their eligibility verification systems.”

Judge Richard Stearns, on the provisions he upheld, wrote that “the government provided a non-frivolous rationale for adopting each provision.”

Source Read the Associated Press report on PBS NewsHour here.

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