Why it Matters
The fight over Medicaid work requirements is moving through federal courts as lawmakers prepare to debate how government assistance programs should encourage employment.
The Senate Special Committee on Aging will hold a Nov. 18 hearing titled "A Bridge, Not a Barrier: Reforming the Safety Net to Reward Work". The hearing comes as several states challenge the Trump administration's implementation of new Medicaid work requirements, raising questions about how the rules could affect access to health care. Sen. Rick Scott (R-FL) chairs the committee, while Sen. Kirsten Gillibrand (D-NY) serves as its ranking member.
Broader Context
Four states are taking the Trump administration to court over Medicaid work requirements. Oregon, Minnesota, New Mexico and Washington filed a lawsuit Nov. 5 seeking to delay implementation of the new rules, STAT reported.
The states argue that the federal government cannot threaten to withhold existing Medicaid funding if they refuse to implement the requirements. The lawsuit seeks to block that enforcement mechanism, but the court has not ruled on the merits of the challenge. The administration has also faced a separate legal setback over exemptions for people with serious medical conditions.
On Nov. 2, Michigan Attorney General Dana Nessel (D-MI) announced that a federal court blocked the administration's revised definition of medical frailty, which determines who can qualify for an exemption from Medicaid work requirements. The ruling prevents the administration from enforcing the challenged definition but does not strike down Medicaid work requirements altogether. Meanwhile, advocacy groups have been lobbying Congress over how the requirements could affect caregivers and families.
Zero to Three, a nonprofit focused on early childhood development, reported lobbying on Medicaid work requirements and caregiver exemptions in four of five quarterly disclosures reviewed. Its lobbying activities also covered the Supplemental Nutrition Assistance Program, housing assistance and the child tax credit.
The organization reported the following lobbying expenses:
- Second quarter of 2025, amended filing: $350,712
- Second quarter of 2026: $119,592
- Fourth quarter of 2025: $59,477
- Third quarter of 2026: $46,493
- First quarter of 2026: $45,892
Together, the five filings account for $622,166 in lobbying expenses. The total covers the organization's lobbying on multiple policy issues, not just Medicaid work requirements. Its fourth-quarter 2025 filing specifically identifies meetings with congressional offices about Medicaid work requirements and exemptions for caregivers, showing that advocates were pressing lawmakers on the issue before the latest legal challenges.
The Bottom Line
The Senate's Nov. 18 hearing comes at a consequential moment for Medicaid policy, with states challenging the Trump administration's work requirements and advocates pushing Congress to protect caregivers and people with serious medical conditions.
While Republicans have framed work requirements as a way to encourage employment and reduce reliance on government assistance, the legal challenges highlight concerns about whether the rules could prevent eligible Americans from receiving health coverage. The hearing will give lawmakers another opportunity to debate that divide as the courts weigh the administration's authority to enforce the requirements.
Access the Legis1 platform for comprehensive political news, data, and insights.
Spot something wrong? Report an issue with this article
