Court decision eases Medicaid work rule, but ‘frailty’ still required

Medicaid recipients with mental health problems who don't work have to prove that they have a condition that qualifies them to continue to receive the health insurance in 2027; until October 29, they also had to demonstrate that the condition would impair them too much to do that work. However, a ruling from the U.S. District Court in Massachusetts eliminated the second requirement. In the suit, in which 26 states sued the Centers for Medicare and Medicaid Services (CMS), Judge Stearns said it was using an unlawful definition of “medically frail.” The Trump Administration's issued Interim Final Rule (IFR) went beyond H.R.1 in choosing its own definition, narrowing the number of people who would be eligible for Medicaid.