Democratic states sue over Medicaid work rules

Half of the states are suing the Trump administration over its directives for implementing Medicaid work requirements, arguing that exemptions for sick people are too narrow and violate administrative law.

Why it matters: Democrats contend the administration's rules will jeopardize care for some of the frailest Americans and cause more upheaval in states that already are rushing to implement the requirements by Jan. 1.

Driving the news: Twenty-five Democratic-led states and the District of Columbia asked a federal court in Massachusetts on Monday to toss out the administration's rule on the new eligibility restrictions.

• The states say the rule goes against congressional intent by making it overly difficult for people to qualify for an exemption from the work requirements due to illness.
• The rule will "cause immediate and irreparable harm" to states' Medicaid programs, the lawsuit says.
• "It will further strain safety net providers, lead to more uncompensated emergency care, and raise other costs associated with newly uninsured, medically frail residents. And it will cause rural hospitals to be even more likely to shutter."

Zoom in: The suit was filed by 23 Democratic attorneys general and the Democratic governors of Kentucky and Pennsylvania, which both have Republican attorneys general.

• The Centers for Medicare and Medicaid Services did not immediately respond to a request for comment.

The states also say CMS's rule veers significantly, in violation of administrative procedure laws, from the guidance the administration had previously given states about how it would implement work requirements.

What we're watching: Medicaid enrollees will be required to log 80 hours of work or approved activities each month as a condition for continuing to receive benefits starting no later than Jan. 1.

• States are required to send notices showing how enrollees can comply with the requirements beginning Aug. 31.