Public Health Leaders and Scholars File Amicus Brief Challenging CMS Medicaid Work Requirement Rule in Taylor v. Kennedy

FOR IMMEDIATE RELEASE
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The American Public Health Association, Grantmakers In Health, the George Washington University Milken Institute School of Public Health’s Jacobs Institute of Women’s Health and National Center for Medical-Legal Partnership, Liberty Health Alliance and 167 public health and health policy deans, chairs and scholars have filed an amicus curiae brief supporting the plaintiffs in Taylor v. Kennedy, a lawsuit challenging a federal Medicaid rule that they argue unlawfully narrows protections for people with serious health conditions. 

The brief challenges provisions of the Centers for Medicare & Medicaid Services’ (CMS) interim final rule implementing Medicaid community engagement requirements, which require certain enrollees to complete at least 80 hours per month of work, community service or education to enroll or maintain eligibility. 

The filing builds on the Health Scholars Legal Initiative’s ongoing efforts to challenge the rule. In July, the initiative submitted comments on the CMS rule, and in September, it filed a similar amicus brief supporting the plaintiffs in Commonwealth of Massachusetts et al. v. Oz et al., a separate lawsuit challenging the same provisions. 

Under legislation enacted by Congress in 2025, certain Medicaid enrollees must meet monthly community engagement requirements. Congress established an exclusion for people who are medically frail or have special medical needs, including people with serious or complex medical conditions, certain disabilities, substance use disorders and disabling mental health conditions. 

“This damaging rule is administrative overreach that will result in the loss of health coverage for millions of Americans,” said Georges C. Benjamin, CEO of the American Public Health Association. “It will disproportionately harm those most at risk, including those with chronic and complex medical conditions. The administration should revoke this rule, and any revised rule must adhere to Congressional intent to honor the exclusions from the community engagement requirements explicitly mandated in the text of H.R. 1.” 

The amici argue that CMS exceeded Congress’s intent by requiring people with qualifying health conditions to also demonstrate that their condition “significantly impairs” their ability to meet the 80-hour requirement. The rule also limits the evidence states can use to determine whether someone qualifies for the medical frailty exclusion. 

“CMS’s rule is arbitrary and capricious. It ignores –  and in important respects contradicts – a wealth of evidence, including CMS’s own data and research, showing that these requirements will lead to significant Medicaid coverage losses and harmful health impacts for people with serious health conditions, the very population that Congress intended to protect,” said Alison Barkoff, Hirsh Health Law and Policy Associate Professor and Program Director at the George Washington University Milken Institute School of Public Health. 

The brief argues that additional documentation and reporting requirements could create significant barriers for people with serious health conditions and lead eligible individuals to lose coverage. The amici also point to evidence from previous Medicaid work requirement experiments in Arkansas and Georgia that found substantial coverage losses without measurable increases in workforce participation. 

“The health and health care consequences of the administration’s medical frailty rule, if allowed to proceed, could not be more serious for health care providers struggling to meet the need for care in medically underserved communities nationwide,” said Sara Rosenbaum, Liberty Health Alliance board chair. 

The amici ask the U.S. District Court for the District of Maryland to grant the plaintiffs’ motion for summary judgment and vacate the challenged portions of the CMS rule. 

The brief can be found here, and an explainer about the case can be found here. 

This filing is part of the Hirsh Health Law and Policy Program’s Health Scholars Legal Initiative. 

Amici are represented by Ropes & Gray LLP. 

The views presented in the brief represent those of the amici and do not necessarily reflect the views of their institutions.

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