MDA applauds new US federal court decision on Medicaid coverage

The Muscular Dystrophy Association (MDA) is hailing a recent U.S. federal court ruling that blocks, at least for now, the implementation of new restrictions that would have made it harder for many people with disabling conditions such as muscular dystrophy to qualify for Medicaid, the government-run program that provides health insurance to disabled and low-income people across the nation.

Specifically, the nonprofit advocacy organization welcomed a decision by the U.S. District Court for the District of Massachusetts that temporarily blocked requirements for work or community service for certain individuals receiving Medicaid. The court’s decision — in a case brought by a team of state attorneys general, who serve as the chief legal officers for their respective U.S. states — will protect exemptions to the new requirements for people deemed medically frail.

Although potential appeals may still proceed, the MDA and other advocates say the court’s ruling is critical for individuals with MD and related conditions.

“[This] decision provides important relief, making it easier for people living with disabilities to gain an exclusion from the Medicaid work reporting requirement,” Paul Melmeyer, executive vice president of public policy and advocacy at the MDA, said in a statement from the association.

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The new ruling concerns a legal dispute over implementation of new Medicaid rules outlined in the large spending package commonly known as the One Big Beautiful Bill Act. Under that law, starting in 2027, people who qualify for Medicaid through the Affordable Care Act’s Medicaid expansion would only be eligible if they do work or community service for at least 80 hours each month.

However, the bill carves out exceptions for people who are “medically frail” — a broadly defined term that covers people with physical disabilities as well as substance abuse and other disorders. That was done to minimize coverage interruptions for people with complex health conditions.

Despite these carve-outs, the Centers for Medicare & Medicaid Services (CMS), which oversees Medicaid, had proposed additional rules that would require people applying for this exception to provide documentation that their condition “significantly impairs” their ability to work — a much narrower definition than what’s covered in the language of the law.

MDA had submitted a ‘friend of the court’ argument in case

A coalition of state attorneys general — led by Andrea Joy Campbell of Massachusetts, Jennifer Davenport of New Jersey, and Rob Bonta of California — sued, saying this rule runs afoul of the carve-out rules in the legislation. The court ruled largely in their favor, blocking these rules from taking effect for now.

“The court ruled that the Trump Administration’s attempt to impose new, burdensome requirements on medically vulnerable Medicaid recipients is unlawful and effectively blocked these harmful rules from taking effect,” Campbell said in a press release issued by her office. “This victory protects access to healthcare for residents with serious illnesses and disabilities and ensures their care won’t be interrupted due to unlawful red tape.”

The MDA had joined with other advocacy organizations in filing an amicus brief — a written legal argument submitted by parties not directly involved in a case — with the court, explaining how these rules would negatively impact people with a wide range of chronic health issues. The term comes from the Latin phrase amicus curiae, which translates to “friend of the court.”

The brief stated that, if implemented, these rules “will harm many medically frail people who do not meet the ‘significantly impairs’ standard but will not be able to work enough to meet the 80-hour minimum work requirement because of social and economic conditions outside of their control.”

This victory protects access to healthcare for residents with serious illnesses and disabilities and ensures their care won’t be interrupted due to unlawful red tape.

In its brief, the MDA also argued that “many others who do, in fact, meet the ‘significantly impairs’ standard will nevertheless lose coverage because they will fall victim to documentation requirements and other administrative barriers.”

Overall, according to the brief, the new rules were projected to reduce nationwide Medicaid enrollment by 10% if implemented.

The brief also noted the specific impacts that this rule would have on the MD community, noting that nearly 40% of people with the condition or related neuromuscular disorders rely on Medicaid for necessary care.

In its statement, the  MDA noted that “for people living with neuromuscular diseases, this decision is an important development.” Further, the nonprofit said it plans to continue to monitor the case “and advocate for Medicaid policies that protect access to essential care and services for people living with neuromuscular diseases.”