25 States Sue Trump Administration Over Medicaid Cuts in One Big Beautiful Bill Act

WASHINGTON, A coalition of 25 states and the District of Columbia sued the Trump administration over the Medicaid provisions of the One Big Beautiful Bill Act, as the year-old law's most consequential eligibility changes near their effective dates.

According to reporting by FOX 56 News, Kentucky Gov. Andy Beshear and Pennsylvania Gov. Josh Shapiro joined governors and attorneys general representing the coalition in filing the 74-page complaint on June 29 in the U.S. District Court for the District of Massachusetts. The suit challenges the administration's interpretation of Medicaid provisions in the law.

The White House did not immediately respond to a request for comment.

President Trump signed the One Big Beautiful Bill Act into law on July 4, 2025, after the House passed the Senate version 218-214. The law passed the Senate in a 51-50 vote, with Vice President J.D. Vance casting the tie-breaking vote. Sens. Susan Collins of Maine, Rand Paul of Kentucky, and Thom Tillis of North Carolina broke with their party and voted against it, along with all Senate Democrats.

The law is now entering its most active implementation phase. According to the American Medical Association, which reviewed the law and has tracked its rollout, the statute includes significant funding cuts and policy changes to Medicaid and the Health Insurance Marketplaces, and restricts states' ability to use provider taxes to finance their Medicaid programs.

The Congressional Budget Office estimates the Medicaid provisions will cause 7.8 million people to lose coverage through a combination of new work requirements, more frequent eligibility checks, reduced federal matching funds, and provider tax reforms, according to an analysis published by BenefitsUSA.

Several deadlines land before the end of the year. Immigrant eligibility restrictions for both Medicaid and SNAP take effect Oct. 1, 2026, according to a timeline compiled by SNAP Eligibility Calculator. Medicaid eligibility redeterminations shift from annual to every six months starting Dec. 31, 2026. The work requirement provision, requiring non-exempt adults ages 19 to 64 to document at least 80 hours per month of qualifying activity, takes effect Jan. 1, 2027, though states may implement it earlier.

Advocates have pointed to Arkansas as a cautionary case. According to BenefitsUSA, when Arkansas ran a similar work requirement program before the federal law took effect, thousands of people lost coverage because of paperwork problems and reporting errors, not because they failed to work. Advocates warn the same pattern could repeat nationally.

The states' lawsuit isn't the first legal challenge. According to the Center for Health Law at Meyers and Raber, a federal judge in Massachusetts issued a preliminary injunction in July 2025 blocking enforcement of the provision that withheld Medicaid funding from Planned Parenthood providers, finding the provision likely unconstitutional.

On the fiscal side, the Center for American Progress has published an implementation timeline showing the law enacts the largest-ever cuts to basic needs programs in U.S. history, structured to offset the cost of extending and expanding the 2017 Trump-era tax cuts.

The National Association of Counties noted in a review of the law that it will likely trigger sequestration of some mandatory funding streams, putting the Social Services Block Grant and Promoting Safe and Stable Families program funds at risk of elimination without additional congressional action.

The Massachusetts district court has not yet issued a ruling or schedule in the states' June 29 case.

Sources cited:
- FOX 56 News (https://fox56news.com/news/kentucky/kentucky-governor-joins-25-states-in-lawsuit-over-trump-medicaid-rule/)
- American Medical Association (https://www.ama-assn.org/health-care-advocacy/federal-advocacy/changes-medicaid-aca-and-other-key-provisions-one-big)
- BenefitsUSA (https://benefitsusa.org/en/blog/medicaid-cuts-2026)
- SNAP Eligibility Calculator (https://snapeligibilitycalculator.com/big-beautiful-bill-food-stamps-changes/)
- Center for American Progress (https://www.americanprogress.org/article/the-implementation-timeline-of-the-one-big-beautiful-bill-act/)
- National Association of Counties (https://www.naco.org/news/us-senate-passes-amended-reconciliation-bill-text-what-it-means-counties)
- PwC Tax Library (https://www.pwc.com/us/en/services/tax/library/overview-of-senate-passed-version-of-hr-1-one-big-beautiful-bill-act.html)