NEW YORK — Attorneys general and governors from 25 states and the District of Columbia filed a lawsuit on June 29, 2026, against the Trump administration regarding new Medicaid work requirement guidance issued by the Centers for Medicare and Medicaid Services.

The plaintiffs allege that an interim final rule from the agency oversteps the text of a law enacted in 2025. This law introduced Medicaid restrictions, including work requirements, as part of a broader tax and policy package. Specifically, the lawsuit claims the administration's interpretation of the statute includes new limits to a medical frailty exemption.

The plaintiffs wrote in the lawsuit, "Added administrative burdens will cause individuals who are eligible for Medicaid to lose or be denied coverage." The filing further states, "People with disabilities, patients in the middle of cancer treatment, or those struggling with another serious or complex health condition, shouldn't be at risk of losing the care that helps maintain their health."

The Centers for Medicare and Medicaid Services issued a rule stating that a condition must impair a person's ability to work, volunteer, or attend school to qualify for a medical frailty exemption. The 2025 law defines medically frail individuals as those with substance use disorders, disabilities, or serious medical conditions. Beginning January 1, 2027, Medicaid expansion enrollees aged 19 to 64 must demonstrate they work or perform community service for at least 80 hours per month, or are enrolled in school at least half-time. Exceptions exist for those considered medically frail or participating in addiction treatment programs. Patients can attest to meeting the definition of medical frailty in 2027 and once in 2028; however, they must prove they meet this definition when renewing coverage in 2028.

New York Attorney General Letitia James stated, "New Yorkers who are battling cancer, living with a disability, managing a serious mental health condition, or recovering from addiction should be able to get the health care they need without being buried in paperwork." Massachusetts Attorney General Andrea Joy Campbell issued a statement saying, "The Trump Administration's attempt to impose new, burdensome requirements on Medicaid recipients threatens access to healthcare for our most vulnerable residents and families." The lawsuit contends that this change in definition contradicts months of regular communications with the agency and preliminary guidance materials.