Boston Judge Blocks Administration's Definition of 'Medically Frail' in Medicaid Rules
Seven Lights
A federal judge in Boston blocked the Trump administration Thursday from enforcing a rule that would have imposed a strict version of Medicaid work requirements on recipients battling illness, ruling the government’s definition of “medically frail” unlawful, The Hill and the Washington Examiner reported.
U.S. District Judge Richard Stearns, a Bill Clinton appointee, sided with 25 Democrat-led states in their lawsuit against the rule. The states had argued the definition would result in chronically ill people being dropped from their insurance coverage.
The dispute traced a boundary between statute and regulation. Congress’s Medicaid work requirements exempt the “medically frail,” a category the statute defines by qualifying conditions. The Centers for Medicare and Medicaid Services rule went further, Stearns found, requiring people in those categories to show additionally that their conditions “significantly impair” their ability to comply with the work requirements. That gloss, the court held, departed from the law.
“States have met their burden of showing irreparable harm for which monetary damages would provide inadequate compensation — they face the burden of costly and intensive modifications to their eligibility verification systems,” Stearns wrote in the 16-page ruling, issuing a temporary injunction against requiring states to determine medical frailty under the stricter rule.
The decision leaves the work requirements themselves standing. Stearns did not strike them down, and he upheld two other elements of the federal framework, confining the judgment to the frailty definition. The ruling nonetheless narrows, for now, the number of ill recipients states may push toward the requirements, and it preserves the broader statutory exemption while the litigation continues.
The Medicaid programme covers tens of millions of Americans, and the requirements take effect state by state. The 25 plaintiff states, led by their attorneys general, brought the challenge over the definition rather than the principle, arguing the agency had rewritten an exemption Congress had written for it.
The administration may seek review of the injunction. Until then, the states need not apply the stricter frailty test, and eligibility systems built for it face the costly revision the judge described.