Five Democratic governors have asked HHS Secretary Robert F. Kennedy Jr. to delay the Jan. 1, 2027, compliance date for Medicaid work requirements, stating that they cannot implement the rules responsibly in the fewer than 100 days that remain.
The Oct. 1 letter was signed by Oregon Gov. Tina Kotek, California Gov. Gavin Newsom, Maine Gov. Janet Mills, New Mexico Gov. Michelle Grisham and Virginia Gov. Abigail Spanberger. It asks HHS to use its enforcement discretion to tie the compliance date to demonstrated state readiness rather than a fixed calendar date.
The governors said CMS’ June 1 interim final rule reversed guidance the agency had given states over the prior year. They pointed to three changes: a definition of medical frailty that goes beyond the statute, new compliance activities that require form and system changes, and a verification hierarchy that requires states to determine a person’s work status before they evaluate compliance or exceptions. The governors said the new system logic, notices and staff training cannot be built and tested in time.
They argued that rushed implementation would cause eligible people to lose coverage. The governors cited CBO estimates that roughly half of expected coverage losses will stem from paperwork and reporting failures. They also said that more than 95% of the people who lost coverage under Arkansas’ 2018 work requirement were later found to have met the requirement or qualified for an exemption.
The governors said they are not seeking an indefinite postponement, and the request does not affect pending state legal challenges to the rule. All five states are among the 25 states and the District of Columbia that sued the Trump administration June 29 over the interim final rule, arguing it unlawfully narrows medical frailty exemptions.
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