Federal judge denies injunction against Medicaid work rules

A federal judge has declined to halt the implementation of new Medicaid work requirements, allowing federal preparations to continue toward a January 1, 2027, deadline. In a ruling issued on July 30, U.S. District Judge Richard Stearns denied a request from 26 states and the District of Columbia for a preliminary injunction, which sought to block the policy while their legal challenge proceeds.

The contested policy stems from the "One Big Beautiful Bill Act" passed by Congress in 2025. It mandates that states implement work requirements for certain Medicaid expansion recipients, requiring nondisabled adults aged 19 to 64 without young children to engage in work, volunteering, education, or job training for at least 80 hours per month to maintain coverage. The law includes an exemption for individuals deemed "medically frail," but the legal dispute centers on new federal guidance that narrows the definition of that term.

The guidance, issued by the Centers for Medicare and Medicaid Services (CMS) in June, states that a formal diagnosis of a serious condition, such as cancer or HIV/AIDS, is not sufficient for an automatic exemption. Instead, beneficiaries must provide additional...