US judge blocks Trump Medicaid rule requiring patients to prove impairment
Judge Richard Stearns sided with 25 states and Washington, DC, in halting a rule that made chronically ill Medicaid recipients prove they were 'medically frail'.
At a glance
- US District Judge Richard Stearns blocked the Medicaid rule on Thursday, siding with 25 states and the District of Columbia.
- The rule would have required chronically ill recipients to show their conditions significantly impair compliance with work requirements.
- The ruling does not strike down Medicaid work requirements, which begin for expansion enrollees on January 1, 2027.
A federal judge in Massachusetts has blocked a Trump administration rule that would have required chronically ill Medicaid recipients to prove they are "medically frail" before they could qualify for an exemption from new work requirements.
US District Judge Richard Stearns ruled on Thursday in favour of 25 states and the District of Columbia, which sued the administration in June over the change. They argued it unlawfully narrowed the exemptions available to people with serious medical conditions.
What the rule would have done
Under federal law, the definition of "medically frail" must include people who are blind or disabled, those with substance use disorders or disabling mental disorders, people with certain disabilities that significantly impair daily activities, and those with serious or complex medical conditions.
The administration's rule went further, requiring people in those categories to show that their conditions also "significantly impair" their ability to comply with the law's work requirements.
Stearns found the states would be harmed if the rule took effect. "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," he wrote in a 16-page ruling.
The Centers for Medicare & Medicaid Services, the agency that adopted the rule, declined to comment.
Work requirements remain in place
Medicaid is a public health insurance programme for low-income people, funded jointly by state and federal governments. Starting January 1, 2027, Medicaid expansion enrollees aged 19 to 64 must show they work or do community service at least 80 hours a month, or attend school at least half of the time. Exceptions exist for those considered medically frail or in addiction treatment programmes, among others.
Stearns's decision makes it easier for some recipients with qualifying medical conditions to obtain an exemption from those requirements, but it does not strike down the work requirements as unlawful.
The judge, who serves in the District of Massachusetts and was appointed by President Bill Clinton, also upheld two other federal restrictions on how states can verify medical frailty that the states and the District of Columbia had contested.
Source: Al Jazeera.
Questions and answers
- Who sued over the Medicaid medically frail rule?
- Twenty-five states and the District of Columbia sued the Trump administration in June, arguing the rule unlawfully limited exemptions for people with serious medical conditions.
- What are the Medicaid work requirements?
- From January 1, 2027, Medicaid expansion enrollees aged 19 to 64 must show they work or do community service at least 80 hours a month, or attend school at least half time. People deemed medically frail or in addiction treatment are among the exceptions.
- Does the ruling end Medicaid work requirements?
- No. Judge Stearns's decision makes it easier for some recipients with qualifying conditions to obtain an exemption, but it does not strike down the work requirements as unlawful.
