Four Democratic attorneys general sued the Trump administration on Thursday, November 5, over the Medicaid work requirements enacted in the 2025 federal budget law. Oregon Attorney General Dan Rayfield filed the complaint in the US District Court in Oregon, joined by Minnesota, New Mexico and Washington. The defendants are Health and Human Services Secretary Robert F. Kennedy Jr., CMS Administrator Mehmet Oz and their agencies.
The law requires Medicaid enrollees aged 19 to 64 to document at least 80 hours a month of work, school or volunteering to keep coverage, with limited exemptions, starting January 1, 2027. The states argue that tying existing federal Medicaid funding to a substantially different eligibility system imposes new conditions Congress had no constitutional authority to attach under the spending clause, and they seek an injunction preventing the federal government from withholding funds if they decline to implement the requirements by January 1. The complaint alleges the overhaul will cause irreparable sovereign, fiscal and public health harms.
The coverage stakes are state sized. Washington officials estimate that at least 20 percent of its Apple Health Medicaid enrollees, approximately 120,000 residents, could lose coverage under the paperwork requirements. Oregon’s attorney general said the rules are unconstitutional and vowed to protect healthcare access in his state.
The filing is the second legal front in a week. On October 29, in Massachusetts v. Oz, a federal court struck down the administration’s narrowed definition of the medical frailty exemption and barred CMS from penalising the 25 plaintiff states and the District of Columbia for implementation errors or delays through April 29, 2027. The new suit is broader: rather than contesting how an exemption is defined, it contests the work requirement conditions themselves. No hearing date has been reported, and the January 1 start remains in force unless a court orders otherwise.