Judge Rejects States’ Attempt to Block Medicaid Work Requirements

The case will proceed, and the court will rule later on whether to block the mandate for many recipients to work or volunteer.

Zachary Stieber

Published: 7/30/2026, 3:25:59 PM EDT

Judge Rejects States’ Attempt to Block Medicaid Work Requirements — The Department of Health and Human Services in Washington on April 29, 2026. (Madalina Kilroy/The Epoch Times)

A federal judge on July 30 declined to block new work requirements for Medicaid recipients that states must implement by Jan. 1, 2027.

U.S. District Judge Richard Stearns, based in Massachusetts, turned down a request for a preliminary injunction made by Massachusetts and 25 other states to block the work requirements as the states’ legal challenge proceeds.

Stearns said in a 6-page decision that the harms about which the states complained—added costs to comply with the new requirements—are largely reimbursable, since the federal government has said it will pay for 90 percent of the costs.

States have also complained that officials face a “tight timeline” to implement the requirements, which include mandating that beneficiaries aged 19 to 64 work, volunteer, or participate in job training for 80 or more hours a month. The timing, though, was set by Congress in the One Big Beautiful Bill Act in 2025, not by the defendant, the Centers for Medicare and Medicaid Services, in its guidance on implementing the requirements, the judge said.

“There is a certain point at which damages fail to justify the issuance of such an extraordinary measure,” Stearns wrote later. “Plaintiffs have not shown that their damages rise above that minimal threshold here. Moreover, the additional costs that may be incurred by the States are unlikely to bloom disproportionately given the familiarity of the responsible state agencies with the tasks to be performed.”

Lawyers for the states and the government did not immediately return requests for comment.

In addition to the Jan. 1, 2027, deadline to implement changes, states in their motion for an injunction noted that under the guidance, they also must inform Medicaid recipients of the looming update in notices by Sept. 1.

The states also opposed the guidance on how to determine whether a person is medically frail, which would exempt them from the work requirements. The guidance “suggests that in no case can States base their determinations of whether an individual is “medically frail” solely on their records that an individual has a ‘particular diagnosis or condition’ and “improperly limits the short-term hardship exception for individuals experiencing an emergency declared by the President to those who can establish that the emergency renders them unable to comply,” state lawyers told the court.

Government lawyers said the One Big Beautiful Bill Act delegated the definition of medically frail to the federal government, and the states are seeking to impose “arbitrary limits” on that authority. They also said the state plaintiffs had not met the standards for a preliminary injunction.

Stearns said Thursday that the court’s denial of the injunction request “is not a reflection or anticipation of its ultimate views on the merits of the underlying litigation,” which will proceed.

“As illustrated in the pleadings and briefings to date (and in the arguments of counsel during the hearing), this case presents difficult issues regarding the scope of Congress’s delegation of interpretative authority to the Secretary and the faithfulness to Congressional intent with which the Secretary performed his task. This, in turn, requires an examination of the data relied upon by the Secretary and the judgments (some medical) that underlay his amplification of Congress’s legislative outline,” the judge stated.

“These are determinations that, in the view of the court, should be made on a developed record of the kind that informs a court’s decision at the summary judgment stage of a case.”

From The Epoch Times