Federal Judge Rejects Trump-Approved Medicaid Work Requirement in Arkansas and Kentucky

Federal Judge Tosses Medicaid Work Requirements

It's not clear yet what impact the rulings, which the Trump administration is likely to appeal, will have on the other states moving forward on work requirement waivers. "We emphatically disagree because a healthcare program like Medicaid, by its very nature, must take into account whether it improves people's health".

The future is less certain in MI, where Democratic Gov. Gretchen Whitmer last month said she would ask the Republican-led Legislature to change newly enacted work or job-related requirements to qualify for Michigan's Medicaid expansion program.

U.S. District Judge James Boasberg issued the simultaneous rulings, voiding the Trump administration's approvals to implement a Medicaid work requirement as well as sending the requests back to the Department of Health & Human Services for further review and suspending the program in Arkansas.

He sent the federal Health and Human Services Department back to the drawing board.

Medicaid is a joint federal-state program - both Congress and the states provide funding, and the states are in charge of administering the program within their borders.

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"As long as they hold on to hope that some judge will rule in their favor, states will continue to pursue work requirements", he said. Similar rules are in effect in IN and New Hampshire.

Craig Wilson, director of health policy at the Arkansas Center for Health Improvement, a nonpartisan health research group, said he believes policymakers will appeal court rulings all the way to the Supreme Court.

Arkansas and Kentucky were early adopters of the Affordable Care Act's Medicaid expansion, which made the program available to people up to 138 percent of the poverty line. "We believe, as have numerous past administrations, that states are the laboratories of democracy and we will vigorously support their innovative, state-driven efforts to develop and test reforms that will advance the objectives of the Medicaid program". Republican Gov. Matt Bevin has been trying to implement the new rules since January 2018, when he first got permission from the Trump administration to implement them.

But at a court hearing earlier this month, the judge foreshadowed his decision, telling attorneys that neither the affordability of Medicaid's expansion nor incentives to get jobs were at the core of the insurance program's goal.

"I am disappointed in the decision handed down late this afternoon". In the Arkansas opinion, he wrote that Azar found only a single element that might promote health coverage, which stated, "a more limited period of retroactive eligibility will encourage beneficiaries to obtain and maintain health coverage, even when they are healthy". The 16 Kentuckians, with the help of their lawyers, again asked Boasberg to block the rules. Since then, 18,000 people have lost their Medicaid benefits. That could strip 450,000 people of coverage.

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The twinned opinions, in a pair of states that have been national leaders in the move towards Medicaid work requirements, cast doubt on the Trump administration's approvals of efforts to re-envision the public insurance program.

IN officials said they planned to move forward with their work requirements despite the ruling.

"Every one of the able-bodied people taking (Medicaid), is taking it right out of the hands, right out of the mouths and right out of the pockets of the people for whom Medicaid was designed", Bevin said.

In Kentucky, expansion supporters fear Bevin will react to the ruling by either trying to end the expansion or by cutting benefits, which he did temporarily after Judge Boasberg first blocked the waiver past year. Beneficiaries here who fail to report work status for 3 months are locked out of the program for the rest of the calendar year.

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