Law & Justice

Judge Blocks Trump Administration’s Medicaid Rule Requiring Chronic Illnesses to Show ‘Significant Impairment’

By Al Jazeera Staff

A federal judge has halted a new rule from the Trump administration that would have required people on Medicaid with chronic illnesses to prove that their conditions “significantly impair” their ability to meet work requirements. US District Judge Richard Stearns, serving in Massachusetts, ruled on Thursday in favor of a lawsuit brought by 25 states and the District of Columbia that challenged the rule. The plaintiffs argued that the rule unlawfully limited exemptions for individuals with serious medical conditions and would prevent eligible Americans from accessing necessary care. Judge Stearns noted that the states had demonstrated irreparable harm that could not be adequately compensated with monetary damages, citing the costly changes the rule would impose on state eligibility verification systems.

The rule would have applied to people who are blind or disabled, have substance use disorders or disabling mental disorders, possess certain disabilities that significantly impair daily activities, or have serious or complex medical conditions. While the law already defines “medically frail” to include these groups, the Trump administration’s rule added the requirement that the conditions also “significantly impair” the ability to comply with work requirements.

The Centers for Medicare & Medicaid Services, which adopted the rule, declined to comment. The ruling does not strike down the work requirements themselves, which will remain in effect. Those requirements, effective January 1, 2027, require Medicaid expansion enrollees aged 19 to 64 to work or perform community service for at least 80 hours a month, or to be enrolled in school for at least half the time, unless they qualify for an exemption. The judge’s decision will make it easier for some Medicaid recipients with qualifying medical conditions to obtain an exemption, but it upholds the broader work requirements.

Judge Stearns also upheld two other federal restrictions on how states can verify medical frailty that were contested by the states and the District of Columbia.