Four states sued the federal government on Thursday, November 5, asking a federal court to block the new Medicaid work requirements that are set to change how hundreds of thousands of adults keep their health coverage from 2027. Washington Attorney General Nick Brown filed the lawsuit against the U.S. Department of Health and Human Services in the U.S. District Court for the District of Oregon in Eugene, and the attorneys general of Oregon, Minnesota and New Mexico joined him as plaintiffs.

Source: Washington Attorney General's Office

The case challenges the work and community-engagement requirements that Congress added to Medicaid through the 2025 federal budget law, H.R. 1. Under those requirements, adults covered through the Affordable Care Act Medicaid expansion must regularly fill out paperwork proving that they are working, in school or volunteering in order to keep their insurance. Implementation does not begin until 2027, and Washington's Health Care Authority guidance still lists January 1, 2027 as the start date for the new requirements and for six-month renewals for Apple Health for Adults — which is why the states have gone to court now, before anyone's coverage changes.

Source: Oregon Attorney General's Office, via EIN Presswire

What is at stake in Washington: Apple Health by the numbers

Medicaid is called Apple Health in Washington. It is the health-care safety net for low-income people, paid for jointly by the states and the federal government, with the federal government covering at least half the cost. More than 1.9 million Washington residents receive health care through Apple Health, covering 15 percent of adults and 36 percent of children in the state. The new paperwork requirements apply only to the expansion group — but that group is large: more than 600,000 people would have to document their work, schooling or volunteering on a regular basis to stay insured.

The Washington Health Care Authority estimates that at least 20 percent of those members may lose coverage because of the new requirements — about 120,000 people. Both state announcements make the same central point about how those losses would happen: in states where similar policies have been implemented, thousands of people have lost health coverage not because they did not qualify, but because they could not keep up with the volume of new paperwork. The attorneys general argue the burden will fall hardest on rural counties, which have higher Medicaid use and higher unemployment, and warn that coverage losses on that scale could force rural health facilities to close, compounding the harm for years.

Oregon's case: 564,177 people on the Oregon Health Plan

Oregon's numbers are similar in scale. Medicaid there is called the Oregon Health Plan, and more than 1.4 million Oregonians receive care through it — 33 percent of adult Oregonians and 55 percent of children up to age 17. The requirements would apply to the 564,177 Oregonians enrolled through the Medicaid expansion, and the Oregon Health Authority estimates that up to one-third of those members may lose coverage. Minnesota and New Mexico joined the suit on the same terms, though their attorneys general did not publish state-by-state loss estimates in the announcements released on Thursday.

Oregon Attorney General Dan Rayfield used similar language: "It would be the height of bureaucratic cruelty to rip away someone's life-saving health care just because of unreasonable paperwork. And yet, that's exactly what Trump's bill does. This is an unconstitutional action by the President, and we will take the steps necessary to stop him — and to protect health care access for thousands upon thousands of Oregonians." Those characterisations are the plaintiffs' political arguments. The legal claim underneath them, as both announcements state it, is narrower: the lawsuit argues that Congress and the federal administration exceeded their constitutional authority by requiring the states to implement these changes.

Background: how the requirements got here, and the earlier paperwork fights

The work requirements were enacted in the 2025 budget bill, H.R. 1, but Congress set implementation for 2027, leaving states to build the paperwork systems in the meantime. Thursday's lawsuit is not the first time either lead state has fought this administration over Medicaid paperwork: both Brown and Rayfield note that they previously blocked implementation of paperwork burdens for seriously ill residents trying to keep their coverage. The new case is broader — it attacks the work-requirement structure itself, for the whole expansion population, rather than one group's paperwork — and it was filed in Eugene, Oregon, which is why an Oregon federal judge will decide it even though Washington's attorney general led the announcements.

Why this matters for working families, including the diaspora

The people in the expansion group are, by definition, working-age adults with low incomes — hourly and shift workers, carers, students and people moving between jobs. For a truck driver paid by the load, a warehouse worker on rotating shifts or a parent juggling two part-time jobs — circumstances common in Washington's Punjabi and wider immigrant communities around Seattle, Tacoma and the I-5 corridor — the risk the states describe is not the work itself but the proof: if the regular documentation is late, incomplete or mismatched, coverage can lapse even for someone who is working full-time. That is an impact assessment based on the mechanism the attorneys general describe, not a count of affected families; neither state published a breakdown by community, and the complaint does not change anyone's coverage today.

What happens next

The filing is a complaint asking the court for relief — it is not a ruling, and it does not by itself change any Apple Health or Oregon Health Plan member's coverage, requirements or renewal notices. The federal government will now have to respond in the District of Oregon, and the case will turn on whether the judge accepts the states' constitutional argument that Washington, Oregon, Minnesota and New Mexico cannot be made to administer the requirements. The practical deadline hanging over the case is January 1, 2027: unless a court blocks them first, the work requirements and six-month renewals are scheduled to begin on that date, so both sides have reason to push for a decision well before the end of 2026.