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# Judge rejects added medical test in Medicaid work rules
- URL: https://justabouts.com/medicaid-work-rules-medical-frailty-court-ruling-2026/
- Published: 2026-10-31T02:03:37.000Z
- Updated: 2026-10-31T02:03:37.000Z
- Description: An Oct. 29 ruling protects the medical-frailty exemption. The broader Jan. 1, 2027, implementation deadline remains in place.
- Author: Justabouts
- Tags: Snohomish County, Camano Island, Help & Resources, Health

A federal judge has rejected an additional test that would have made it harder for some people with serious health conditions to qualify for an exemption from new Medicaid work requirements.

Washington joined the states that brought the case. For Apple Health members in Snohomish and Island counties, the Oct. 29 decision concerns an important protection for people with medical needs, while leaving the broader implementation deadline of Jan. 1, 2027, in place.

## What the judge changed

Congress excluded people who are medically frail or have certain special medical needs from the new requirements. The law names categories including blindness or disability under Social Security rules, substance use disorders, disabling mental disorders, certain disabilities affecting daily activities, and serious or complex medical conditions.

The Centers for Medicare & Medicaid Services added another condition: people in those categories would also have to show that their health condition significantly impaired their ability to comply with the work requirements.

U.S. District Judge Richard G. Stearns, in Massachusetts, ruled that the agency had gone beyond the law Congress passed. He struck that additional language from the rule and granted an injunction against enforcing it.

## What remains in place

The decision leaves the remainder of the rule intact. Stearns rejected the states’ challenges to a 12-month lookback for medical claims and encounter data and a limit of one self-attestation of medical frailty during a continuous enrollment period.

The plaintiff states also received a six-month enforcement pause concerning determinations of whether a person qualifies as medically frail. The court expressly said that this limited pause does not change Congress’s Jan. 1, 2027, implementation deadline.

The ruling therefore addresses one exemption and how it is assessed. It does not suspend all Medicaid work requirements or decide whether a particular person qualifies for Apple Health.

## What Apple Health members can do

Keep eligibility notices and check the specific reason for any requested action. A letter about a medical exemption raises different questions from one about income, renewal paperwork or immigration eligibility. Ask the Health Care Authority which rules apply to your coverage and what information it needs for the decision described in your notice.

The [Washington Attorney General’s announcement](https://www.atg.wa.gov/news/news-releases/win-washington-judge-blocks-unlawful-federal-implementation-medicaid-work?ref=justabouts.com) links to the [full court decision](https://agportal-s3bucket.s3.us-west-2.amazonaws.com/Federal%20Litigation/dkt%20147%20opinion%20on%20MSJ.pdf?VersionId=7vreJGlptF.J.OUItCICZphx0K0bYc.7&ref=justabouts.com). The ruling’s explanation of the relief appears on pages 14–16, including the footnotes preserving the Jan. 1 implementation date.

*Verified Oct. 30, 2026, against the court’s Oct. 29 decision.*