The One Big Beautiful Bill Act imposes 80-hour monthly work mandates across 44 states starting Jan. 1, 2027.
Five Medicaid enrollees and leading medical organizations sued the Trump administration on Friday, Sept. 18, 2026, in federal court in Maryland to block new Medicaid work requirements. The suit says a June 2026 rule sharply narrows who qualifies for the law's exemption for the "medically frail."
The plaintiffs. Enrollees from Kentucky, Illinois, Indiana, Missouri and North Carolina joined the American College of Physicians, the American Academy of Pediatrics and the city of Columbus, Ohio.
The barrier. Worth knowingA disability diagnosis, or even an existing disability determination, does not by itself grant the medically frail exemption under the June 2026 rule. The enrollee has to document that the condition is what prevents work, or they fall under the 80-hour monthly requirement.
Where it stands. The One Big Beautiful Bill Act's work, school or community service conditions apply across 44 states, and the Maryland court has not set a hearing.
BackgroundWhat Arkansas's 2018 work-reporting rule did to enrollees
- 18,164 Arkansas adults aged 30 to 49 lost Medicaid coverage before a federal judge halted that state's reporting policy in April 2019.
- 76% of good-cause exemptions Arkansas approved from July through December 2018 were granted for portal and technical reporting problems, not medical ones.
- 55% of nonelderly adult Medicaid recipients in Arkansas who reported a disability were not on SSI, leaving them subject to the work rules.