AG Brown sues over unlawful federal implementation of Medicaid work requirements

The federal administration's unlawful implementation of new Medicaid work requirements will make it even harder for people with challenging medical conditions to get the healthcare they need, Attorney General Nick Brown and a coalition of 23 other attorneys general and two governors argue in a new lawsuit filed today.

"With this new rule, people struggling with serious health issues face an impossible choice-jeopardize their health by trying to meet new, stringent work requirements or lose health coverage entirely," Brown said. "Washington state is stronger when all people can get the care they need, and I'm committed to protecting Medicaid as a vital safety net."

The lawsuit challenges provisions of an interim final rule published by the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) on June 3, 2026, regarding new Medicaid work requirements passed by Congress last year. Medicaid is the nation's safety net healthcare program for low-income Americans.

Congress created exemptions from Medicaid's work requirements to ensure that people with serious illnesses and disabilities do not lose coverage or face interruptions in care. Despite months of working with states on implementation, CMS surprised states with the interim final rule, "Community Engagement Requirement for Certain Individuals," which adopted a new interpretation of key terms like "medically frail" and makes it harder for medically vulnerable individuals to be excused from the work requirements.

The interim final rule makes other changes that increase administrative burdens, create unnecessary red tape, and put eligible people at risk of losing their health coverage-including those who are already working or qualify for an exemption. The rule disregards substantial evidence that should have been considered, fails to adequately evaluate reasonable alternatives, and does not give states clear or workable guidance. Past Medicaid work requirement programs have shown that added red tape causes eligible people to lose coverage, placing greater strain on state Medicaid programs, safety net providers, and emergency rooms, while increasing costs as more medically frail residents become uninsured.

While the work requirement provision applies beginning January 1, 2027, states must notify Medicaid recipients about these changes beginning August 31, 2026, and need significant lead time to prepare those communications. As a result, the attorneys general seek to block implementation of the interim final rule's illegal provisions and have them ultimately struck down.

States raised concerns with CMS about potential last-minute changes. For instance, Gov. Bob Ferguson and five other governors wrote to HHS Secretary Robert F. Kennedy, Jr., on May 29 requesting that the administration give states additional time to implement the requirements if the interim final rule included substantive policy changes.

Apple Health is Washington's Medicaid program and insures approximately 1.9 million individuals, including some of the most vulnerable people in the state, such as those experiencing homelessness or who have serious or complex medical conditions.

In today's lawsuit, the coalition alleges that the interim final rule:

• Unlawfully narrows Congress's protections for medically frail Medicaid recipients.
• Violates the Administrative Procedure Act by ignoring substantial evidence that work reporting requirements cause eligible individuals to lose healthcare coverage because of administrative barriers rather than a failure to work.
• Fails to adequately consider the significant harms that will be imposed on states, Medicaid beneficiaries, healthcare providers, and state healthcare systems.
• Unconstitutionally coerces states by imposing new compliance requirements after states had already begun implementing the One Big Beautiful Bill Act based on the statute's plain language and CMS's prior guidance.

The lawsuit was co-led by California Attorney General Rob Bonta, Massachusetts Attorney General Andrea Joy Campbell, and New Jersey Attorney General Jennifer Davenport. In addition to Brown, they were joined by the attorneys general of Arizona, Colorado, Connecticut, Delaware, District of Columbia, Hawai'i, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, and Wisconsin, as well as the governors of Kentucky and Pennsylvania.

A copy of the complaint is available here.

-30-

Washington's Attorney General serves the people and the state of Washington. As the state's largest law firm, the Attorney General's Office provides legal representation to every state agency, board, and commission in Washington. Additionally, the Office serves the people directly by enforcing consumer protection, civil rights, and environmental protection laws. The Office also prosecutes elder abuse, Medicaid fraud, and handles sexually violent predator cases in 38 of Washington's 39 counties. Visit www.atg.wa.gov to learn more.

Media Contact:

Email: [email protected]

Phone: (360) 753-2727

General contacts: Click here

Media Resource Guide & Attorney General's Office FAQ