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Oregon is seeking an urgent injunction to stop the Trump administration from withholding existing Medicaid funding if the state does not implement new work requirements.
The requirements of H.R. 1, the “One Big Beautiful Bill Act,” apply to the 564,177 Oregonians enrolled in the Oregon Health Plan (OHP) through the Affordable Care Act Medicaid expansion.
The Oregon Health Authority estimates that up to one-third, or about 188,000 people, could lose coverage because of the new requirements.
The changes will create new barriers to receiving Medicaid through OHP, says Oregon Attorney General Dan Rayfield. Rural counties with high Medicaid enrollment and unemployment rates could be hardest hit.
Attorneys general from Minnesota, New Mexico, and Washington joined Oregon’s November 5 lawsuit.
What the Trump Administration’s Medicaid Rules Require
Starting in 2027, affected adults aged 19 to 64 must meet work or activity requirements unless they qualify for an exemption.
Qualifying routes include 80 hours a month of work or approved activities, enrollment in education at least half-time, or monthly income above the current $580 threshold.
Tidings Data Snapshot
Ways to Meet OHP’s New Activity RulesAlternative qualifying routes for affected adults in 2027| Route | Monthly requirement |
|---|---|
| Work or approved activities | 80 hours |
| Education | At least half-time |
| Household income | More than $580 |
These are alternatives, not three requirements to complete together. Exempt members do not need to meet the work or activity rules. The income threshold reflects the current federal minimum wage.
Source: Oregon Health Authority / Federal Changes to OHP; four-state complaint, page 12DailyTidings.com
OHA says affected adults will also have to renew eligibility every six months starting in late 2027.
Exemptions include certain disabilities, serious medical conditions, pregnancy, and caring for a child under 14 or someone with a disability.
People who are “medically frail”, including those who are blind or disabled, have a substance use disorder, or a serious or complex medical condition, are exempt from the work requirements.
H.R. 1 also changes federal funding eligibility for some legally present immigrants. However, OHA says affected members can retain full OHP benefits through Healthier Oregon, the state-funded program covering people regardless of immigration status.
The law also shortens the period for retroactive Medicaid coverage.
What Oregon and the Other Three States Are Seeking to Block
The attorneys general are seeking injunctive relief to prevent the federal government from withholding existing Medicaid funding from states that refuse to implement the work requirements.
Their complaint argues that threatening existing funding exceeds Congress’s constitutional authority. The states say the requirements will cause irreparable harm to their authority, finances, and public health.
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