Federal judge rejects new Medicaid ‘frailty’ definition for work requirements
A federal court blocked an added work-impairment condition while leaving the broader work requirements in place.
TL;DR
- A federal judge rejected an added condition in the federal definition of medical frailty for Medicaid work-requirement exemptions.
- The case was brought by 25 states and the District of Columbia, and the underlying work requirements remain in place.
- The judge also provided states a 6-month grace period from enforcement and penalties while verification systems are updated.
A federal judge rejected part of the federal definition of medical frailty used to exempt some people from Medicaid work requirements. Judge Richard D. Stearns ruled in a case brought by 25 states and the District of Columbia. [1] [2]
The Centers for Medicare & Medicaid Services rule added a requirement that a qualifying condition significantly impair a person’s ability to work. The Associated Press reported that the judge blocked that added requirement. [2] [3]
The decision does not invalidate the work requirements themselves. The Associated Press reported that the judge left other limits on verifying medical frailty in place, including a restriction on older documentation. [2]
The Washington Post reported that the judge provided states a 6-month grace period from enforcement and penalties to update verification systems. The longer-term outcome remains uncertain, with another challenge to the rule still pending. [3]
Why it matters
The ruling changes how affected states must verify an exemption before Medicaid work requirements begin. The underlying work requirements were not struck down, and some verification restrictions were upheld.
Editor's note
STAT’s report is partially paywalled; the Associated Press and The Washington Post independently report the ruling. The decision addresses the challenged exemption condition, not the validity of all work requirements. The linked court order returned 403 during review.