CONNECTICUT — A federal judge on Thursday struck down an extra restriction on who can qualify as medically frail under new Medicaid work requirements, granting part of the relief sought by Connecticut and a coalition of states.
U.S. District Judge Richard G. Stearns ruled that the Centers for Medicare & Medicaid Services exceeded its authority by requiring people in Congress’s listed medical categories to also show that their condition significantly impaired their ability to meet the work, study or community-service requirement.
The distinction matters for people with serious medical needs. Congress identified categories that include blindness or disability, substance-use disorders, disabling mental disorders, certain disabilities affecting daily activities, and serious or complex medical conditions. The judge concluded that CMS could not add the disputed functional test across those categories.
The decision vacates that added language and provides a permanent injunction against its enforcement or implementation. It also gives the plaintiff states a six-month enforcement stay concerning determinations of whether a person qualifies as medically frail, to accommodate changes to their verification systems.
That stay does not move the January 1, 2027, deadline Congress set for implementation. The opinion expressly preserves that deadline. The ruling does not eliminate the underlying work requirements or establish any individual resident’s eligibility.
The states did not prevail on every issue. Stearns rejected their challenges to the rule’s twelve-month lookback period for medical claims and encounter data and its limit on self-attestation. He found that the federal government had adequately explained those provisions under the applicable administrative-law standard.
Connecticut is named among the plaintiffs in the case, Commonwealth of Massachusetts and others v. Mehmet Oz and others, docket 1:26-cv-12962-RGS. Attorney General William Tong’s office announced the decision Thursday after joining the multistate challenge in June.
The practical next step for the states is to adjust verification systems to reflect the narrower ruling. This report does not establish how Connecticut will revise individual notices or procedures; those details were not supplied in the announcement reviewed.
This report was prepared with AI assistance from the court’s October 29 memorandum and order, read in full through the copy published by the California attorney general, and Connecticut’s official announcement. The image is an official court website file photograph of the John Joseph Moakley U.S. Courthouse in Boston, where Stearns serves; it does not depict the hearing.