New Jersey is one of 24 states suing the Trump administration over new rules it says will make it harder for sick people to stay on Medicaid. (iStock / Getty Images Plus)
New Jersey is one of two dozen states that sued the Trump administration Monday claiming that work rules the federal government recently issued for the Medicaid program are unlawful in how they reduce protections for people who are medically frail.
Led by New Jersey Attorney General Jen Davenport and Massachusetts Attorney General Andrea Joy Campbell, the 74-page complaint alleges a federal rule issued June 3 goes far beyond what is contained in the law Trump signed last July that requires certain adults in Medicaid to document that they are working, volunteering, or in school at least 20 hours a week to continue receiving healthcare benefits.
The work requirement, which starts in January, applies to some 550,000 Medicaid members in New Jersey, primarily low-income adults. The lawsuit focuses largely on how the new rules define “medically frail,” a category of recipients who are automatically exempt from proving that they are employed.
“The rule makes it harder to access Medicaid by shrinking exemptions to the work requirement,” Davenport told reporters Monday.
The law suggests “medically frail” includes people who are disabled, have chronic or complex health conditions, or are struggling with substance abuse.
Davenport said that under the new rule, a doctor’s diagnosis alone may not excuse Medicaid enrollees from work, noting that patients still may need to “jump through bureaucratic hoops” to prove that this condition also “significantly impairs” their ability to work.
“Imagine that you are diagnosed with stage 4 cancer and that’s still not enough to prove you can’t work the hours this administration requires to allow you lifesaving care,” she said.
In all, Medicaid covers about 1.8 million Garden State residents, and state officials predict at least 360,000 will lose their benefits because of the federal changes.
Monday’s lawsuit, filed in federal court in Massachusetts, targets the Centers for Medicare and Medicaid Services, which issued the rule, and the U.S. Department of Health and Human Services, which oversees the centers. The department did not respond to a request for comment.
The lawsuit also claims the new rule ignores real-world evidence from states that have implemented work rules in Medicaid, changes that have not increased employment levels but have shown to strip eligible residents of their benefits over paperwork errors alone. The administration also didn’t consider that multiple studies have shown at least two-thirds of Medicaid recipients nationwide are already working, in school, or caring for a loved one, it notes.
The lawsuit also faults the Centers for Medicare and Medicaid Services for placing an unlawful burden on states with the rule, which differs significantly from the guidance the agency had provided state officials earlier in the process. State governments have until August 31 to communicate the changes to Medicaid members, a timeline the attorneys general say is now impossible given the concepts outlined in the new rule.
“Defendants’ action will cause immediate and irreparable harms to Plaintiff States’ operation of their state Medicaid programs. It will further strain safety net providers, lead to more uncompensated emergency care, and raise other costs associated with newly uninsured, medically frail residents. And it will cause rural hospitals to be even more likely to shutter,” the complaint reads.
The other states in the lawsuit are: California, Arizona, Colorado, Connecticut, Delaware, District of Columbia, Hawai‘i, Illinois, Kentucky, Maine, Maryland, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and Wisconsin.
