AG Brown joins 23-state coalition suing Trump administration over Medicaid rule

Washington State Attorney General (AG) Nick Brown, a coalition of 23 other attorneys general, and two governors filed a lawsuit Monday over the unlawful implementation of Medicaid work requirements.

The federal administration’s illegal work requirements for Medicaid make it more challenging for people with medical conditions to get the healthcare they require, a news release from the AG’s office stated.

“With this new rule, people struggling with serious health issues face an impossible choice — jeopardize their health by trying to meet new, stringent work requirements or lose health coverage entirely,” Brown said. “Washington state is stronger when all people can get the care they need, and I’m committed to protecting Medicaid as a vital safety net.”

Coalition alleges the rule unlawfully narrows protections for vulnerable recipients

The lawsuit is aimed at provisions of an interim final rule that was published by the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) on June 3, regarding newly imposed Medicaid work requirements passed by Congress in 2025.

In the lawsuit, the coalition alleged that the interim final rule does the following:

• Unlawfully narrows Congress’s protections for medically frail Medicaid recipients.
• Violates the Administrative Procedure Act by “ignoring” substantial evidence that work reporting requirements cause eligible individuals to lose healthcare coverage due to administrative barriers, instead of a failure to work.
• Fails to adequately consider the harm that will be imposed on states, Medicaid beneficiaries, healthcare providers, and state healthcare systems.
• Unconstitutionally coerces states by imposing new compliance requirements after states had already started implementing the One Big Beautiful Bill Act based on the statute’s language and CMS’s prior guidance.

Congress made exemptions from Medicaid’s work requirements to ensure that people who have serious illnesses or disabilities don’t lose coverage for care. According to the AG’s office, CMS surprised states with an interim final rule after months of working alongside states on implementation.

The rule, “Community Engagement Requirement for Certain Individuals,” adopted a new interpretation of key terms such as “medically frail,” making it harder for medically vulnerable individuals to be excused from the work requirements.

The interim final rule also made other changes that increase administrative burdens, create unnecessary red tape, and put eligible people at risk of losing health coverage, even those who were already working or qualified for an exemption.

“The rule disregards substantial evidence that should have been considered, fails to adequately evaluate reasonable alternatives, and does not give states clear or workable guidance,” the AG’s office stated.

AGs say states are being rushed into an unworkable timeline

Former Medicaid work requirement programs showed that added red tape causes eligible people to lose their coverage. That loss strains state Medicaid programs, safety net providers, and emergency rooms, increasing costs and leaving more medically frail residents uninsured.

The work provision begins Jan. 1, 2027, but states must notify Medicaid recipients about the changes on Aug. 31, and need significant time to prepare any communications. The attorneys general are seeking to block implementation of the interim final rule’s illegal provisions and have them struck down.

The AG’s office noted that other states and their governors have raised concerns with CMS about any potential last-minute changes, including Washington Governor Bob Ferguson and five other governors, who wrote to HHS Secretary Robert F. Kennedy Jr. in a request that the administration give states more time to implement the requirements if the interim final rule were to include substantive policy changes.

The lawsuit was co-led by the attorneys general of California, Massachusetts, and New Jersey. In addition to Attorney General Nick Brown, they were joined by the attorneys general of Arizona, Colorado, Connecticut, Delaware, District of Columbia, Hawai‘i, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, and Wisconsin, as well as the governors of Kentucky and Pennsylvania.

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