26-state coalition files lawsuit to block Medicaid work requirement rule

A coalition of 26 states has filed a lawsuit in the District of Massachusetts challenging CMS's final rule that allows states to impose community engagement or work requirements on certain Medicaid beneficiaries. The rule, finalized on June 29, 2026, is the administration's latest attempt to permit states to mandate work or volunteer activities as a condition of Medicaid eligibility for non-elderly, non-pregnant adults. Legal challenges to earlier iterations of Medicaid work requirements were largely successful in federal courts, which found they were incompatible with the core objective of the Medicaid program to provide healthcare coverage. The outcome of this lawsuit will determine whether states like Arizona, Montana, and New York can proceed with planned or newly implemented requirements that could affect coverage for hundreds of thousands of beneficiaries. Monitor the docket for this case, as it will shape state Medicaid policy and patient access for years.