
On October 29, 2026, New Jersey Attorney General Jennifer Davenport announced that a U.S. District Court in Massachusetts issued a permanent injunction against a Trump administration rule that sought to narrow Medicaid work‑exemption protections for medically frail individuals.
The court found the Centers for Medicare & Medicaid Services (CMS) lacked authority to add new requirements that states assess whether a person’s condition significantly impairs their ability to work. The decision vacates the contested language and grants a six‑month stay of enforcement.
The interim final rule, issued by CMS, attempted to reinterpret the “medical frailty” exemption in the One Big Beautiful Bill Act (OBBBA). It would have required states to apply additional bureaucratic screens, potentially forcing many low‑income New Jerseyers with serious illnesses, mental health issues, or substance‑use disorders to prove they could not work before keeping Medicaid coverage.
Source: New Jersey Attorney General
Congress created the exemption to ensure people with serious health conditions do not lose Medicaid benefits. The judge ruled that CMS’s attempt to narrow the exemption contradicted the statutory language of OBBBA, making the rule contrary to law.
People who qualify as “medically frail” – those with complex or serious medical conditions, mental disorders, or substance‑abuse disorders – will continue to be exempt from work requirements under Medicaid. The six‑month stay gives states time to adjust their systems without risking loss of coverage for these individuals.
Anyone currently receiving Medicaid who worries about meeting work requirements should contact their local Medicaid office to confirm they are classified as medically frail and that no new paperwork is needed.
The decision reinforces that federal agencies cannot expand their authority beyond what Congress authorizes. Other states in the multistate coalition, including California and Massachusetts, will benefit from the same injunction.
While the rule is blocked now, the administration could attempt a revised rule. Affected individuals should stay informed about any future changes and keep records of their medical status.
Consulting an attorney may be helpful for anyone who has been asked to provide additional proof of medical frailty or who faces a potential loss of Medicaid benefits.
The ruling keeps Medicaid available for medically frail individuals, preventing loss of care for those with serious health conditions.
The decision signals courts will scrutinize agency attempts to expand rules beyond congressional intent.
The administration may draft a new rule, so affected people should monitor CMS announcements.
The six‑month stay lets states modify systems without immediate enforcement, reducing administrative strain.
If you receive new paperwork about work ability, consult an attorney to protect your Medicaid rights.
This article is general information based on New Jersey Attorney General and court or agency records available at publication time. It is not legal advice; laws and deadlines differ by state and by case. Published October 29, 2026.
Source: New Jersey Attorney General
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