Coalition of prosecutors sues Trump over new Medicaid rule
According to the lawsuit, the new definition of "medically fragile person" will force beneficiaries to submit additional and unnecessary documentation
A coalition of attorneys general from 24 states and the District of Columbia has filed a lawsuit against President Donald Trump's administration to stop a new federal Medicaid rule that they say illegally tightens requirements for maintaining health coverage and could leave hundreds of thousands of people with serious illnesses, disabilities or mental health conditions uninsured.
The lawsuit, filed in federal court in Boston, requests to immediately suspend the application of the rule while the litigation is resolved and, later, declare it invalid on the grounds that it exceeds what was approved by Congress and violates US administrative law.
The challenge is directed against an interim rule issued by the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), responsible for implementing the new work requirements included in the so-called “One Big Beautiful Bill Act,” approved by Congress in 2025.
New York Attorney General Letitia James, who heads the coalition, said Congress established clear exceptions for people considered “medically fragile,” including those with cancer, disabilities, complex illnesses, serious mental disorders or substance use problems.
However, he argued that the regulation published by the Trump administration added an additional requirement that does not appear in the legislation: requiring these beneficiaries to demonstrate that their condition significantly prevents them from working or complying with new work obligations.
“New Yorkers battling cancer, living with a disability, managing serious mental illness, or recovering from addiction should be able to receive the medical care they need without being buried in red tape,” James said in a statement released by his office. “This rule creates unnecessary barriers for some of our most vulnerable neighbors.”
According to the prosecutor, this interpretation took the states by surprise, which for months had worked with federal officials to prepare the implementation of the law under criteria different from those finally adopted by the CMS.
The plaintiffs maintain that the new regulation violates the Administrative Procedure Act by being “arbitrary and capricious,” contradicting the text approved by Congress and not adequately assessing the impact it will have on both beneficiaries and state governments.