Federal Judge Blocks Part of Medicaid “Medically Frail” Rule, but Work Requirements Still Start January 1

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Worried elderly woman looking out window
Piksel

A federal judge in Boston sided with 25 states and the District of Columbia and blocked a CMS rule that would have required people in the “medically frail” category to also prove their condition significantly impairs their ability to meet Medicaid work requirements. That category includes people who are blind or have a disability, a disabling mental health condition, or a serious or complex medical condition. The ruling does not end the work requirements, which begin January 1, 2027 for most expansion adults ages 19 to 64. Two limits remain in place: states may reject proof of a diagnosis older than 12 months, and may accept only one self-attestation per continuous enrollment period. CMS has not said whether it will appeal. Anyone who receives a noncompliance notice has 30 days to show an exemption, so keeping recent medical documentation on hand is a practical step.

Read More: Medical Daily

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Note: Summaries are for general information and are not legal or financial advice. Please verify program details with the agencies involved.