Federal judge blocks narrow Medicaid medical frailty rule for work requirements

Judge Richard D. Stearns of the U.S. District Court of Massachusetts ruled on Thursday that federal regulators exceeded their authority by narrowing the definition of medical frailty. STAT News reported that the decision addresses exemptions for individuals with medical issues who are subject to Medicaid work requirements. The ruling followed a lawsuit brought by more than two dozen states. [1]

According to STAT News, Judge Stearns determined that the federal regulations regarding who is considered too sick to work were overly restrictive. He also ruled that states did not have adequate time or resources to overhaul their eligibility systems to meet the new standards. [1]

Medicaid finances a broad range of services including hospital care, physician visits, long term care, and preventive services. Total Medicaid spending reached 931.7 billion dollars in 2024, with federal funding constituting the majority of expenditures and state budgets spending an average of 28.8 percent on the program. [4]

The court decision injects new uncertainty into the imminent rollout of Medicaid work requirements across the country. STAT News reported that the states successfully demonstrated the challenges of implementation under the restricted federal definition. [1]