Court Rules in Favor of Medicaid Work Requirement Exemption

A federal district court in Massachusetts has ruled in favor of a coalition of states challenging provisions of a Trump administration rule governing exemptions from new Medicaid work requirements.

The decision concerns the rule’s treatment of individuals who qualify as medically frail. 

On June 1, 2026, the Centers for Medicare and Medicaid Services issued an interim final rule to guide states in implementing the Medicaid work requirements, scheduled to take effect Jan. 1, 2027. 

The rule required individuals seeking a medical frailty exemption to demonstrate that their qualifying condition also significantly impaired their ability to comply with the work requirements.

Qualifying conditions include blindness or disability, substance use disorders, disabling mental disorders, disabilities that significantly impair daily activities, and serious or complex medical conditions. 

The court’s ruling did not invalidate the Medicaid work requirement.

Following publication of the rule, 26 states, including Connecticut, filed a challenge in the U.S. District Court in Massachusetts.

Among the contested provision was the requirement that individuals demonstrate how their qualifying medical condition affected their ability to comply with the work requirements. 

Connecticut Attorney General William Tong welcomed the decision and said his office would continue efforts to protect access to Medicaid. 

The court’s ruling did not invalidate the Medicaid work requirement and upheld other federal restrictions on how states verify medical frailty.

The decision removes the challenged additional condition for the exemption, potentially making it easier for recipients with qualifying medical conditions to obtain an exemption when the work requirements take effect. 

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For more information, contact CBIA’s James Rocco.