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Health Care · Report · File No. 261113-437

Pallone and Wyden urge CMS to let states delay Medicaid work rule before Jan. 1

Two top congressional Democrats asked Medicare chief Mehmet Oz to give every state more time before Medicaid work reporting starts Jan. 1, 2027. They say states' systems aren't ready and people could lose coverage.

By the Kitchen-Table Desk · · 2 min read

Every quote in this story (2) was matched word for word against its source. How we work

My clippings
Frank Pallone
Frank Pallone. Photo: US House, Public domain

Two senior Democrats in Congress asked the Trump administration on Nov. 12 to immediately delay Medicaid work reporting requirements, which take effect Jan. 1, 2027 1. Rep. Frank Pallone of New Jersey and Sen. Ron Wyden of Oregon wrote to Mehmet Oz, who runs the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees Medicaid 1. Pallone is the top Democrat on the House Energy and Commerce Committee, and Wyden is the top Democrat on the Senate Finance Committee 1.

Under the rule, many Medicaid recipients must work, volunteer or study for 80 hours a month to keep coverage 2. Medicaid is the joint federal-state health program for low-income Americans.

What the Democrats are asking

The lawmakers asked CMS to use its legal authority to give states more time 1. They want all states, consistent with applicable law, to be allowed to delay coverage denials and terminations tied to the work rules. That would last until eligibility systems, verification processes and protections for enrollees are fully implemented and tested 1.

It is clear that CMS must permit all states, consistent with applicable law, to delay denials and terminations
Frank Pallone and Ron Wyden, House Energy and Commerce ranking member, D-N.J., and Senate Finance ranking member, D-Ore., in a letter to CMS1

They also asked CMS to grant "good faith" exemptions to every state that requests one 1. The letter says CMS leadership is discouraging states from seeking them 1. They want CMS to publish state readiness assessments, exemption requests and decisions. Once the rules start, they want state-level data on coverage denials and terminations 1.

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The court fight and the Senate push

On Oct. 29, a federal court ruled in Massachusetts v. Oz that CMS exceeded its authority by narrowing who counts as medically frail and is excused from the requirement 3. People now need only a condition in one of five categories set by law, not proof that it limits their ability to work 3. KFF, a health policy research group, says the ruling applies nationwide 3.

KFF's summary of the ruling does not say it changes the Jan. 1 start date 3. Nextgov reports that no state delay has been granted 2.

On Monday, 16 Senate Democrats, led by Sens. Raphael Warnock of Georgia and Ben Ray Luján of New Mexico, asked their leaders for a two-year delay 2.

Raphael Warnock
States had fewer than 18 months to make complex eligibility and enrollment systems changes.
Raphael Warnock, U.S. senator, D-Ga.2

What happens next

The requirements start before Democrats take control of Congress in January 2. A House Democratic working group memo from September urges reversing Medicaid cuts within the first 100 hours of the next Congress 2. Wyden said the work requirements would be reversed "as quickly as possible" 2.

Pallone has named reversing Medicaid cuts a top priority in his bid to chair the Energy and Commerce Committee 2. CMS has not publicly answered the letter in the sources we reviewed.

That matters because states have until Jan. 1 to build systems that check work hours and exemptions. Critics say a tight timeline raises the risk that eligible people lose coverage because of paperwork errors, not because they don't qualify.

The Record

  1. A federal court rules in Massachusetts v. Oz that CMS unlawfully narrowed the medically frail exemption; the ruling applies nationwide 3.
  2. Sixteen Senate Democrats ask leaders for a two-year delay in implementing Medicaid work requirements 2.
  3. Pallone and Wyden ask CMS Administrator Oz to let states delay coverage denials and terminations tied to the work rules 1.
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Sources

  1. House Energy and Commerce Committee Democrats, “Pallone and Wyden Call on Trump Administration to Immediately Delay Implementation of Medicaid Paperwork Requirements” (2026-11-12). democrats-energycommerce.house.gov/media/press-releases/pall
  2. Nextgov/FCW, “Democratic Congress likely to scrutinize Medicaid work requirements, Medicare AI test” (2026-11-12). nextgov.com/digital-government/2026/11/democratic-congress-l
  3. KFF, “Court Decision Eases Burden of Proof to Qualify for Medical Frailty Exclusion to Medicaid Work Requirements” (2026-10-29). kff.org/quick-insights/court-decision-eases-burden-of-proof-

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