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A federal judge has blocked part of a Trump administration rule that could have made it harder for seriously ill and disabled Oregonians to keep their Medicaid coverage.
Court Protects Medical Exemptions After Oregon Joins Legal Challenge
The October 29 ruling followed a lawsuit brought by Oregon and a coalition of other states challenging changes to the definition of “medically frail” under new federal Medicaid requirements.
The changes, introduced by the Centers for Medicare & Medicaid Services (CMS), would have required people seeking an exemption from new work requirements to show that their medical condition significantly impaired their ability to meet those requirements.
In Oregon, Medicaid is administered through the Oregon Health Plan.
Judge Richard G. Stearns of the U.S. District Court for Massachusetts ruled that CMS had exceeded its authority by adding this condition to the categories of people Congress had already designated as medically frail.
Those categories include people who are blind or disabled, have a substance use disorder or disabling mental disorder, or live with a serious or complex medical condition.
The court ordered the additional test removed and issued a permanent injunction against its enforcement.
Added Exemption Test Is Blocked While Other Requirements Remain
However, the ruling did not overturn all the new requirements. The judge upheld a 12-month lookback for claims and encounter data and a limit of one self-attestation of medical frailty per continuous period of enrollment.
Tidings Data Snapshot
What the Medicaid Ruling ChangesOctober 29, 2026 decision on medical-frailty exemptions| Provision | Court’s decision |
|---|---|
| Extra impairment test | Blocked |
| 12-month claims-data lookback | Upheld |
| One self-attestation per enrollment period | Upheld |
| Medical-frailty determinations | Six-month enforcement stay |
| January 1, 2027 implementation deadline | Unchanged |
The lookback covers claims and encounter data. The self-attestation limit applies to each continuous period of enrollment. The court did not overturn the underlying federal work-requirements law.
Source: U.S. District Court, Massachusetts / October 29, 2026, Document 147DailyTidings.com
Under the new federal law, affected Medicaid recipients must complete 80 hours of work or community service each month, or attend an educational programme at least half-time, unless they qualify for an exemption.
The work and activity requirements are scheduled to take effect January 1, 2027.
The court also granted the states a six-month stay of enforcement on determinations of medical frailty to allow time for adjustments to eligibility systems, but did not change the implementation deadline.
Attorney General Dan Rayfield welcomed the ruling, saying it would allow people fighting cancer or living with disabilities to focus on their health rather than the risk of losing coverage.
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