加州总检察长 Bonta 诉讼胜诉：联邦法院撤销 Medicaid「医疗脆弱」定义并发布永久禁令
加州总检察长 Rob Bonta 办公室10月29日宣布，马萨诸塞联邦地区法院裁定特朗普政府实施 Medicaid（联邦医疗补助）工作要求的方式违法，撤销联邦医疗保险与医疗补助服务中心（CMS）对「医疗脆弱」（medically frail）的定义，发布永久禁令，并给予原告州六个月的执行暂缓期。
这起诉讼由 Bonta 与一个多州联盟于2026年6月提起，挑战 CMS 在《大美丽法案》（Big Beautiful Bill Act）框架下出台的临时最终规则。该规则收紧了「医疗脆弱」的认定口径，使重病与残障人士更难获得工作要求豁免。法院认定该定义违反法律。
Bonta 表示，这项裁决保障了最脆弱居民的医疗可及性；他说，重病或残障人士不应该因为工作要求或相关手续障碍而担心失去医疗保障。
Medicaid 是面向低收入人群的安全网医疗计划，由联邦与各州共同出资，联邦至少承担50%的服务成本。国会此前为该计划的工作要求设立了豁免条款，以确保重病与残障人士不失去保障。
Attorney General Bonta Wins Court Ruling: Federal Court Vacates Medicaid 'Medically Frail' Definition and Issues Permanent Injunction
California Attorney General Rob Bonta announced on October 29 that the U.S. District Court for the District of Massachusetts had ruled the Trump Administration's implementation of new Medicaid work requirements unlawful, vacating the federal definition of "medically frail," issuing a permanent injunction, and granting the plaintiff states a six-month stay of enforcement.
Bonta and a multistate coalition sued in June 2026 over an interim final rule from the Centers for Medicare & Medicaid Services (CMS) under the Big Beautiful Bill Act, which adopted a narrower interpretation of "medically frail" and made it harder for medically vulnerable people to be excused from the work requirements. The court held the definition contrary to law.
"Today's decision is a major victory that ensures that some of our most vulnerable residents are able to continue to access the healthcare they deserve," Bonta said. "People with serious illnesses or disabilities should not have to worry about losing their healthcare because of work requirements or related barriers."
Medicaid is the nation's safety-net health program for low-income Americans, jointly funded by the states and the federal government, which covers at least 50 percent of the cost of services. Congress created exemptions from the work requirements to ensure people with serious illnesses and disabilities do not lose coverage.
来源：GSM·美国（原文链接）
图片来源：图：萨克拉门托的加州总检察长办公室大楼。Coolcaesar 摄，CC BY-SA 3.0，经 Wikimedia Commons。 / The California Attorney General's office building in Sacramento. Photo by Coolcaesar, CC BY-SA 3.0, via Wikimedia Commons.
