Attorney General Jackson Wins Court Ruling Protecting Healthcare for More than 60,000 North Carolinians with Serious Illnesses
Federal judge strikes down unlawful Medicaid restriction that threatened patients with cancer and other severe illnesses
FOR IMMEDIATE RELEASE
Thursday, October 29, 2026
Contact: comms@ncdoj.gov
919-538-2809
RALEIGH – Today, Attorney General Jeff Jackson won a federal court ruling striking down a new Medicaid restriction that threatened life-saving healthcare coverage for an estimated 64,000 North Carolinians with cancer and other serious illnesses.
In June, Attorney General Jackson sued the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services after the agencies imposed a new requirement that made it harder for seriously ill patients to keep their Medicaid coverage.
Attorney General Jackson sued, arguing that CMS had exceeded its authority by narrowing an exemption Congress explicitly created. Under its new rule, a cancer patient undergoing chemotherapy could have been required to prove not only that they were seriously ill, but also that their illness prevented them from meeting an 80-hour monthly work requirement.
Today, U.S. District Judge Richard Stearns agreed. The court ruled that CMS lacked authority to impose the additional restriction, ordered the unlawful language removed from the rule, and granted a permanent injunction against its enforcement.
“When we filed this lawsuit, I told people battling cancer and other serious illnesses to focus on getting better and let us handle the legal fight,” said Attorney General Jeff Jackson. “Today, we won that fight. Congress specifically protected these patients, and CMS broke the law by trying to take that protection away. The judge agreed and struck down the restriction.”
“This ruling is a victory for North Carolinians fighting serious illnesses,” said NC Health and Human Services Secretary Dev Sangvai. “One of our top priorities is to make sure people can get the critical health care they need without facing confusing paperwork or the fear of losing coverage during treatment. This decision allows us to focus on what matters most: delivering reliable health care to our state’s most vulnerable residents when they need it most.”
The ruling protects North Carolina’s ability to implement the new Medicaid requirements without imposing the unlawful additional test on patients. NCDHHS and county social services departments had already begun preparing for the changes when CMS adopted its unlawful definition, creating additional administrative burdens and costs.
The broader Medicaid work requirements remain scheduled to take effect January 1, 2027.
Background on the case:
When Congress passed H.R. 1, it created new Medicaid work requirements but specifically exempted people who are medically frail, including people with cancer, muscular dystrophy, cystic fibrosis, hemophilia, Parkinson’s, and other serious conditions.
CMS then narrowed that exemption.
That could have meant additional medical records, doctor’s notes, evaluations, and paperwork, with patients potentially losing coverage while still receiving life-saving treatment.
North Carolina brought the case alongside the Attorneys General for Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Virginia, Washington, and Wisconsin, and the Governors of Kentucky and Pennsylvania.
A copy of today’s ruling is available here.
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