Trump Medicaid work requirements stay in place after judge’s ruling: Who could lose coverage? Rules explained

Federal Judge Richard J. Stearns upheld the Trump administration's Medicaid work requirements, rejecting a request from Democratic-led states for a temporary block.

The policy requires certain Medicaid expansion beneficiaries to complete 80 hours per month of work, volunteering, or school to keep coverage, with a January 1, 2027 implementation deadline.

The lawsuit challenges rules requiring 'medically frail' recipients to prove they cannot meet work requirements, as the administration says a diagnosis alone may not qualify for an exemption.

Stearns denied the preliminary injunction, citing that the federal government covers 90% of implementation costs and states' harm did not meet the threshold for an extraordinary measure.

The ruling allows states to continue preparations, but the judge left the door open for states to seek a pause later with new evidence of harm.