THE ARISING · Markets & Strategy
Four States Sue Over Medicaid Work Requirements
Oregon, Minnesota, New Mexico and Washington filed a November 5 challenge to work requirements for the Medicaid expansion population, ahead of implementation in 2027.
Oregon Attorney General Dan Rayfield filed the suit November 5 in the U.S. District Court in Oregon. Minnesota, New Mexico and Washington joined, according to the complaint and Oregon Department of Justice.
The requirements come from the One Big Beautiful Bill, passed in 2025. They apply to specified adults aged 19–64 in the Medicaid expansion population, not every Medicaid recipient. Routes to compliance include 80 hours of work or community service, qualifying income, or at least half-time education. Exclusions include pregnancy, medical frailty and certain caregiving responsibilities.
The complaint alleges the overhaul will cause "irreparable sovereign, fiscal, and public-health harms." It also argues the administration does not have the authority to force states to put these changes in place.
For insurers, health systems and others who plan around Medicaid enrollment, the deadline now sits alongside active litigation. The states say the harms fall on their budgets, their authority and public health.
Next to watch: whether the court grants relief before implementation in 2027. Filing a complaint does not itself suspend the requirements.