Medicaid enrollees from five states and leading medical organizations filed a lawsuit Friday challenging new Medicaid work requirements. (Photo by Whitney Downard/Indiana Capital Chronicle)
Medicaid enrollees from five states and leading medical organizations have filed a lawsuit challenging new Medicaid work requirements.
The broad tax and spending law that President Donald Trump signed last summer, known as the One Big Beautiful Bill Act, established work, school or community service requirements for low-income adults who receive Medicaid under expansion provisions and waiver programs across 44 states. The law exempts people who are medically frail from work requirements, but the lawsuit argues a new administration rule severely restricts who qualifies.
Plaintiffs in the lawsuit filed Friday in the U.S. District Court for the District of Maryland include Medicaid enrollees from five states — Kentucky, Illinois, Indiana, Missouri and North Carolina.
They also include the American College of Physicians, the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, Doctors for America, the New Hampshire Medical Society, the New Hampshire Chapter of the American Academy of Pediatrics and the city of Columbus. The National Health Law Program and the Democracy Forward Foundation are representing the plaintiffs.
“Creating barriers to healthcare coverage for the most vulnerable needlessly puts people’s lives at risk and inevitably drives up the cost of care for everyone,” Columbus City Attorney Zach Klein said in a news release. “These are folks who should be focused on getting the help and care they desperately need, not overcoming even more obstacles.”
The federal government in June issued a rule that specifies “medical frailty” exemptions from the work requirements. Those include people who are blind or disabled, or have any physical or developmental disability that interferes with daily living; people with substance use disorders or disabling mental disorders; or those with “serious or complex” medical conditions. People who fall in these categories still must prove that their conditions hinder their ability to work or participate in community engagement.
Republicans argue that work requirements would push people into the workforce and allow them to come off government aid. Research shows the majority of Medicaid recipients already work or are in school.
The plaintiffs argue that the new designations are narrow and that work or exemption verification processes will create red tape that threatens Medicaid coverage for people with serious or chronic health conditions. Those who could be harmed under the new rule include people with cancer, diabetes, HIV, substance use disorders and other behavioral health conditions, the lawsuit argues.
Individuals represented in the lawsuit have health conditions ranging from autism spectrum disorder, obsessive compulsive disorder, bipolar disorder, severe vision impairments, HIV and narcolepsy.
Work requirements will be costly for cities and localities that provide public health and emergency care services, the plaintiffs argue, as many people may lose coverage.
“When they (cities and localities) provide services for residents who lose their Medicaid coverage, they do so without compensation,” the lawsuit reads.
Medical groups are concerned the reporting burdens will cause interruptions in care and coverage for low-income, vulnerable adults.
“We should not and must not be implementing policies that place this already vulnerable population at increased risk of interrupted treatment, disrupted coverage, or losing healthcare access altogether,” said Dr. Jan K. Carney, president of the American College of Physicians.
Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Iowa Capital Dispatch, and is supported by grants and a coalition of donors as a 501c(3) public charity.