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Federal judge blocks Arkansas and Kentucky Medicaid work requirements

April 1st, 2019 | ThinkProgress Staff

A federal judge struck down Medicaid work requirements in Arkansas and Kentucky on Wednesday, temporarily blocking one of the Trump administration’s most consequential health policies.

U.S. District Judge James Boasberg ruled that the federal government did not properly justify the need for the work requirements given the number of people who would lose health coverage.

This is the second time Boasberg blocked Kentucky’s Medicaid work requirements. In June 2018, he said the administration didn’t adequately consider the significant coverage loss if Medicaid eligibility was conditioned on reported work. In response, Kentucky officials resubmitted a nearly identical waiver.

Boasberg ultimately agreed with advocacy groups that sued on behalf of Medicaid enrollees, and ruled that the state and federal administration had not done enough to differentiate between the two waivers.

“The Court cannot concur that the Medicaid Act leaves the Secretary so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose,” wrote Boasberg in his Kentucky decisionWednesday. “As a consequence, once again finding the reapproval was both contrary to the Act and arbitrary and capricious, the Court will vacate it and remand to HHS for further review.”

The judge cited coverage loss in Arkansas as further proof.

Over 18,000 low-income Arkansans lost health coverage last year because they didn’t meet the work and reporting requirements. Of these 18,164 residents, only 8 percent have reapplied and regained coverage in 2019. Thousands more were on track to lose coverage this year if they didn’t report hours for three consecutive months. Kentucky’s revised work requirements were supposed to be implemented April 1.

Boasberg called Arkansas’ waiver “arbitrary and capricious because it did not address — despite receiving substantial comments on the matter — whether and how the project would implicate the ‘core’ objective of Medicaid: the provision of medical coverage to the needy.”

Advocacy groups that sued on behalf of Medicaid beneficiaries were pleased with the decision.

“Medicaid is federal and state program designed to provide health care, it is not and never has been a program intended to encourage work,” Jane Perkins, legal director of the National Health Law Program, said in a statement. “The law is about providing health care services to low-income individuals and families and underserved populations. It is nonsensical and illegal to add obstacles to Medicaid for large groups of individuals who are already working or full-time health care providers for family members or suffering chronic health matters that prevent them from work.”

Advocacy groups are also suing the Trump administration for approving Medicaid work requirements in New Hampshire.

This article was originally published at ThinkProgress on March 27, 2019. Reprinted with permission. 

About the Author: Amanda Gomez covers health policy. She previously worked at the PBS NewsHour.

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