Rep. Frank Pallone Jr. of New Jersey, the ranking member of the House Energy and Commerce Committee, and Sen. Ron Wyden of Oregon, the ranking member of the Senate Finance Committee, made the request in a letter released Thursday to Centers for Medicare and Medicaid Services Administrator Mehmet Oz. Both lawmakers are set to become committee chairmen in early January when Democrats regain control of Congress.

The lawmakers urged CMS to use its "discretion to give states additional time to implement work reporting requirements and protect eligible beneficiaries from losing coverage." They warned that failing to allow a delay "despite known operational deficiencies will worsen preventable coverage losses for which Congressional Democrats will hold the Trump Administration accountable."

The requirement stems from the sweeping domestic policy law Republicans approved in summer 2025, which included major changes to Medicaid, the state-federal health program for lower-income Americans and some people with disabilities. Under the provision, Medicaid enrollees between the ages of 19 and 65 must work, perform community service, or attend an education program for at least 80 hours a month.

The law includes exceptions for pregnant people, parents of dependent children, people with complex medical conditions, tribal community members, those in the foster care system, people under 26 who were in foster care, and individuals released from incarceration in the last 90 days, among others. Republicans also carved out an exemption for people who are "medically frail" or have "special medical needs" as defined by the secretary.

This summer, CMS released an interim final rule telling states how to determine whether someone is medically frail and therefore exempt from the 80-hour requirement. But that part of the implementation is on hold after a federal judge issued a ruling in an ongoing lawsuit, which Pallone and Wyden said makes it even harder for states to enforce the new rules once they begin.

The lawmakers pressed Oz to reconsider what types of diagnoses the administration considers qualifying for the "medically frail" exemption. "In one example, even a diagnosis of cancer could be insufficient to meet CMS' extra-statutory definition of 'medically frail,'" they wrote.

Pallone and Wyden also called on Oz to approve any "good faith exemptions" states have submitted to CMS to secure more time for implementation. "Congress gave CMS flexibility in the statute for a reason; the agency should not direct states away from good faith exemptions out of concern that they highlight the shortcomings of this policy—not when Americans' access to health care hangs in the balance," they wrote. "We intend to rigorously oversee CMS' determinations on good faith exemptions and its decision to demand states to proceed with implementation even when out of compliance with federal requirements."

The push comes as the nonpartisan Congressional Budget Office projected in July 2025 that changes across the law would result in 10 million people losing access to health care. In West Virginia, state officials said this week that about 40,000 of the state's 160,000 Medicaid enrollees will likely lose coverage in January because of the new work requirements.

The letter signals that Democrats plan to use their incoming committee gavels to scrutinize the administration's implementation of the Medicaid changes, setting up a potential clash over health coverage early in the new Congress.