WASHINGTON — Chronically ill people on Medicaid won’t be bound by new work requirement rules that the latest Trump administration guidance requires in order to qualify for “medically frail” exemptions, a federal judge ruled Thursday.
U.S. District Judge Richard Stearns in Boston gave a partial victory to a coalition of 25 states and the District of Columbia, which sued the Trump administration in June over the new Centers for Medicare and Medicaid Services guidance linked to the 2025 law known as the “One Big Beautiful Bill.
“The states have met their burden of showing irreparable harm for which monetary damages would provide inadequate compensation — they face the burden of costly and intensive alterations to their eligibility verification systems,” Stearns said in his 16-page ruling.
Additionally, Stearns upheld two other federal restrictions on how states can verify medical frailty: including the requirement that states reject proof of patients’ medical frailty if the diagnosis is more than a year old. He also upheld a policy allowing states to accept only one self-attestation per continuous period of enrollment. The change affects those covered through an expansion in most states that gave more lower-income people access to the government’s safety net healthcare program.
The new Medicaid restrictions are part of Trump’s big tax and policy law in 2025.
Explaining why he upheld the portions in favor of the government, Stearns said “the government provided a non-frivolous rationale for adopting each provision and explained why it did not find the States’ concerns of disenrollment compelling.
