25 States and DC Sue Trump Over Medicaid Work Rule

A coalition of 25 states and the District of Columbia filed a lawsuit on Monday, June 29, 2026, challenging the Trump administration's implementation of new Medicaid work requirements. The suit, filed in federal court in Massachusetts, argues that a recent rule unlawfully restricts exemptions for medically vulnerable recipients.

The rule, issued by the U.S. Centers for Medicare and Medicaid Services earlier this month, provides guidance for states implementing work requirements enacted as part of the One Big Beautiful Bill Act, a tax and spending law signed in 2025. Under the law, most adults aged 19 to 64 covered by Medicaid expansion must complete at least 80 hours per month of work, community service, education, or job training to maintain coverage, with the requirements scheduled to take effect on January 1, 2027.

The lawsuit centers on exemptions for people considered "medically frail." The states contend that while Congress provided broad categorical exemptions for individuals with serious medical conditions, disabilities, or substance use disorders, the new CMS rule narrows those protections. The rule requires individuals to prove their condition "significantly impairs"...