Judge blocks tighter Medicaid medical exemptions, not work requirements
Stearns sided with 25 states and the District of Columbia against a rule requiring chronically ill Medicaid recipients to prove themselves “medically frail” to obtain work exemptions. The decision blocks that restriction but leaves the underlying work requirements intact. [5][8]
Why it matters
Beginning January 1, 2027, Medicaid expansion enrollees aged 19–64 must meet work, community-service or schooling conditions unless exempt; the ruling makes exemptions easier to obtain for some people with qualifying medical conditions. [8]
Key insights
- The dispute concerns who qualifies for an exemption, not whether Medicaid work requirements themselves are lawful. [8]
- The law's medically frail category must include people with serious or complex medical conditions, alongside specified disabilities, substance use disorders and disabling mental disorders. [8]
- The remaining requirement is at least 80 hours of work or community service a month, or attendance at school at least half the time, subject to exceptions. [8]