State AGs sue over Medicaid work requirements and more news from the states

Good evening. Tonight we begin in the West, where states attorneys general are challenging the Trump administration’s Medicaid work rules. And patients and officials worry about the fate of the only organ procurement organization that manages life-saving donations for a sprawling territory. 

In Missouri, voters again cast ballots resoundingly in favor of access to reproductive healthcare, but Republican lawmakers are considering what restrictions they could pursue next year in light of another ballot measure meant to prohibit legislative meddling. 

After Tuesday’s election, the lame-duck session of Congress is set to begin next week with a long to-do list, including keeping the government open past mid-December. 

As you’re out this weekend, consider listening to Stories From The States. And thank you for all of your support during this busy election season. 

Four Democratic state attorneys generals are suing the Trump administration over its plan to enact work requirements for people enrolled in Medicaid beginning in 2027, Oregon Capital Chronicle reports.  

The attorneys general of Oregon, Minnesota, New Mexico and Washington filed the federal lawsuit, arguing that Congress and the Trump administration exceeded their constitutional authority by requiring states to implement the new rules, which require monthly reports from Medicaid recipients proving they work, attend school or volunteer at least 80 hours a month. 

Oregon Attorney General Dan Rayfield said the rules are unconstitutional and vowed to protect healthcare access for Oregonians. 

“It would be the height of bureaucratic cruelty to rip away someone’s life-saving healthcare just because of unreasonable paperwork,” he said in a statement. “And yet, that’s exactly what Trump’s bill does.”

More than 1.4 million Oregonians receive healthcare through the Oregon Health Plan — the state’s Medicaid program. It covers 33% of adult Oregonians and more than half of children under age 17.  

For hundreds of Montanans who are on an organ transplant list, the wait for a life-saving donor comes with the added difficulty of being hundreds of miles away from the nearest medical transplant center. Guidelines proposed by the Trump administration could mean the only organization coordinating transplant services in Montana might lose certification, leaving already sick patients with even fewer options, Daily Montanan reports. 

That’s why Montana’s congressional delegation — four Republicans — signed onto a letter with other western states lawmakers asking the Trump administration to reconsider its decision.

Federal delegations, medical providers and advocacy groups said a change in how the government regulates organ transplants could have massive downstream effects, potentially closing as many as half of the organizations that provide those services across the country.

Montana is one of four states without an organ transplant center and has just one provider of the service — LifeCenter Northwest, which is in Washington. It also serves Alaska and part of Idaho.

Arkansas’ Republican attorney general asked a federal judge to end a 35-year-old order establishing multiple majority-Black judicial districts in the state, Arkansas Advocate reports. 

Attorney General Tim Griffin cited a U.S. Supreme Court ruling that weakened a key part of the Voting Rights Act.

Griffin’s filing was criticized by civil rights advocates who said the decree ensured a more representative judicial system.

Washington: The Trump administration can’t force state election officials to set aside ballots from 400-plus voters alleged to be noncitizens, a federal judge ruled. 

Montana: Fewer than 48 hours after voters passed a ballot initiative to ban corporations, organizations and “artificial entities” from contributing to candidates, the measure is being challenged in federal court. 

Michigan: Two lawsuits have been filed against Proposal 2, the “Michiganders for Money Out of Politics” ballot measure that passed on Tuesday with more than 80% of the vote, arguing it violates the First Amendment. 

North Carolina: Voters passed constitutional amendments to impose limits on local governments’ power to raise property taxes and cap the state income tax, which could have lasting effects on school construction and other government programs.

Wisconsin: An infant has died of measles — the state’s first death from the viral illness since 1990.

Kentucky: Private information about patients with confirmed cases of measles was publicly accessible through the state’s disease dashboard in September. 

North Dakota: Native American communities experience some of the highest healthcare disparities in the country. Tribal chairs are hoping to work with U.S. Health and Human Services Secretary Robert F. Kennedy Jr. to remedy that. 

Alaska: A federal judge ruled that regulators acted improperly when they granted a permit in 2024 for a controversial gold mining project, which was set to be the backdrop of a new reality television show.

Maine: After Democratic Gov. Janet Mills vetoed a temporary statewide data center moratorium earlier this year, voters in several towns approved local ordinances this week. 

New Hampshire: A legislative panel has recommended reconsidering legislation to expand rabies vaccine exemptions for state pets. 

South Dakota: The state is expanding a hunting-license buyback program as reported deer deaths from epizootic hemorrhagic disease jump to 791.

Dr. Margaret Baum, chief medical officer of Planned Parenthood Great Rivers, embraces Margot Riphagen, president and CEO of Planned Parenthood Great Rivers, during an Amendment 3 watch party in St. Louis. The crowd celebrated after the ballot measure aimed at banning abortion was voted down by Missourians on Tuesday. (Photo by Anna Spoerre/Missouri Independent) 

About 55% of voters rejected Amendment 3, preserving the constitutional right to abortion approved in 2024. Voters also approved Amendment 6, which sharply limits lawmakers’ power to overturn citizen-approved measures.

The results dealt a significant setback to anti-abortion activists who had hoped Missouri could provide a national model for reversing abortion rights victories at the ballot box.

But state Sen. Nick Schroer, a St. Charles County Republican who will become Senate majority leader in January, said abortion will remain a priority for his caucus, even as lawmakers grapple with the new restrictions imposed by Amendment 6.

Read more from Missouri Independent. 

Related coverage: 

Voters may have given Democrats control of Congress in the midterm elections, but Republicans will remain in charge of both chambers during the lame-duck session that spans November and December, States Newsroom’s D.C. Bureau reports. 

The relatively brief five-week schedule, which begins Monday, gives GOP leaders a chance to wrap up unfinished work before handing over power when the new session begins in early January. 

Congress could send the president several major pieces of legislation during that time, including the annual defense policy bill, the farm bill, a measure to regulate the college sports landscape and permitting reform to ease regulation on large construction projects.

But lawmakers must pass a government funding bill before Dec. 11 to avoid another shutdown.

President Donald Trump announced Friday he will elevate Stephen Miller to White House chief of staff, the first shake-up of his administration officials since Democrats trounced Republicans in the midterms, the D.C. Bureau reports. 

Former Chief of Staff Susie Wiles will move to the “Trump Political Operation,” the president announced in an afternoon post on his Truth Social platform.

Trump said Miller, a key figure behind the administration’s aggressive mass deportation campaign, is “one of my most trusted advisors.” 

House Minority Leader Hakeem Jeffries slammed the move, writing on X Friday that Miller “is a dangerous xenophobe and reckless extremist who has American blood on his hands.”

More national headlines: 

An enormous blue wave crashed over all levels of government this midterm cycle. Congressional seats, governor’s mansions and state legislatures flipped from Republican to Democrat, some in surprising fashion. Democrats claimed “trifecta” power in some state capitals, broke supermajorities in others and won other influential statewide offices.

For months, the Trump administration tried to assert federal control over the election process to bolster Republicans’ chances of maintaining power. President Donald Trump pushed GOP-led states to gerrymander their congressional districts, demanded state voter rolls through legal challenges and threatened to send armed federal agents to the polls.

Despite fears about possible interference or intimidation heading into Election Day, voters turned out en masse and have shifted the course of policymaking over the next several years in their states and on Capitol Hill.

In Episode 53, we’re reflecting on the state of American democracy, election integrity and what Tuesday’s results could mean for policymaking in reshaped statehouses.

Listen to Stories From The States below, or subscribe on Apple Podcasts, Spotify or Youtube.

Colorado House Democrats on Friday elected Rep. Jennifer Bacon of Denver to serve as the next speaker of the chamber. She will be the first Black woman to hold the position, Colorado Newsline reports. 

Bacon will lead a Democratic supermajority in the 76th General Assembly, which will convene on Jan. 11. She will succeed Speaker Julie McCluskie, a Dillon Democrat who is term-limited and won’t return to the chamber in January. 

“I know that my job is to help lift you up, lift up your communities, share successes, share insights and fight for you,” Bacon said to House Democrats.