Four state AGs sue over Trump’s Medicaid work requirements

Four Democratic state attorneys generals are suing the Trump administration over its plan to enact work requirements for people enrolled in Medicaid beginning in 2027. 

In 2025, the massive federal tax and spending law championed by President Donald Trump and congressional Republicans put forth new rules requiring that Medicaid enrollees between ages 19 and 64 prove through monthly paperwork that they are employed, attending school or volunteering at least 80 hours a month. 

The law has exemptions for people who are pregnant or postpartum, disabled or medically frail, parents or caretakers of children younger than 14. People with disabilities and American Indians and Alaska Natives are also exempt. 

The Democratic attorneys general of Oregon, Minnesota, New Mexico and Washington filed a lawsuit Thursday afternoon in the U.S. District Court in Oregon, arguing that Congress and the Trump administration exceeded their constitutional authority by requiring states to implement these changes. 

Centers for Medicare and Medicaid Services Administrator Mehmet Oz and U.S. Secretary of Health and Human Services Secretary Robert F. Kennedy, and the agencies they represent, are listed as the defendants in the lawsuit. A spokesperson for the Centers for Medicare and Medical Services said the agency does not comment on pending litigation, and spokespeople for the health and human services department did not immediately respond to a request for comment Friday morning.

Oregon Attorney General Dan Rayfield said the rules are unconstitutional and vowed to protect healthcare access for Oregonians. 

“It would be the height of bureaucratic cruelty to rip away someone’s life-saving healthcare just because of unreasonable paperwork,” he said in a statement. “And yet, that’s exactly what Trump’s bill does.”

More than 1.4 million Oregonians receive healthcare through the Oregon Health Plan — the state’s Medicaid program. It covers 33% of adult Oregonians and more than half of children under age 17.  

Oregon estimates the requirements will apply to nearly 40% of Oregon Health Plan enrollees, a third of whom the Oregon Health Authority estimates may lose coverage because of the extra paperwork they’ll have to comply with to maintain their healthcare.

More than 1.9 million residents in Washington, including 15% of the state’s adults and more than a third of children, receive healthcare through the state’s Medicaid program Apple Health. State officials estimate at least 20% of those members, or about 120,000 people, may lose coverage because of the new requirements. 

“This administration’s changes to Medicaid are the latest cruel effort to shred the safety net for tens of thousands of Washingtonians,” said Washington Attorney General Nick Brown. “This red tape will make people lose their health insurance, stop going to the doctor when they’re sick and rely on our public hospitals for emergency care when inevitable health issues spiral out of control.”

Rural communities are expected to be hit the hardest because of higher Medicaid utilization and unemployment rates. State officials expect rural healthcare facilities to face greater financial hardship should the work requirements take effect.