Medicine

Federal Judge Strikes Down Medicaid Work Rules in Kentucky, Arkansas

Federal Judge Strikes Down Medicaid Work Rules in Kentucky, Arkansas

A federal judge today tossed out work requirements created by Kentucky and Arkansas for people to receive Medicaid benefits, writing in separate opinions that HHS approval of both programs failed to consider the core objective of Medicaid-to provide healthcare for the needy.

The Trump administration reapproved the rules in November.

FILE - In this September 12, 2018, file photo, Arkansas Gov. Asa Hutchinson, center, talks at a news conference at the State Capitol in Little Rock, Ark., about the state's work requirement for its expanded Medicaid program. So he said that because so many people are losing insurance, especially in Arkansas, that that state would have to stop its Medicaid work requirement program right away.

Kentucky's Medicaid program would have required people to get a job, go to school or volunteer to keep their health benefits.

U.S. District Judge James Boasberg said in the Arkansas decision that federal approval of the program was arbitrary and capricious because it didn't address whether it would affect medical coverage to the needy-a core objective of Medicaid.

In the new Kentucky ruling, Boasberg rejected the latest argument by the secretary of the Department of Health and Human Services-that the almost 100,000 people who would lose coverage as a result of work requirements would be dwarfed by the 450,000 who would lose coverage if Kentucky decides that it won't participate in the Medicaid expansion that was part of the Affordable Care Act. "Additionally, individuals who have not complied with the work and community engagement requirement from January to March 2019 can not be removed from the program for noncompliance going forward".

Adam Meier, secretary for the Kentucky Cabinet for Health and Family Services, said the judge's ruling was illogical. Similar rules are in effect in IN and New Hampshire.

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A spokesman for Republican Gov. Mike DeWine in OH said his administration was reviewing the ruling to see if it would have any effect on that state's requirement, which is expected to take effect in 2021.

Several states, including Virginia and Kentucky, have used the prospect of work rules to build support among conservatives to support Medicaid expansion, which was one of the key provisions of the Affordable Care Act.

"I am disappointed in today's decision and am reviewing the decision and coordinating with state and federal officials to determine the appropriate course of action".

In Kentucky, Republican Gov. Matt Bevin has threatened to end his state's Medicaid expansion if work requirements are ultimately struck down. It's responsible for adding some 12 million people to the Medicaid rolls in the 37 states that accepted the expansion.

HHS and the CMS have approved the waivers on the grounds that they enhance beneficiary health and financial independence and the fiscal sustainability of Medicaid.

Boasberg reached the same conclusion when he first ruled on Kentucky's program last summer. He found that the states' requirements pose numerous obstacles to getting health care that have gone unresolved by federal and state officials. Beneficiaries who did not comply with the work and community engagement requirements for three consecutive months in 2018 and were removed from the program have always been eligible to reapply for coverage through the Medicaid expansion program. Politically, of course, work requirents are relatively popular, and tend to put progressives in the hard position of defending a failure to work by allegedly able-bodied beneficiaries, even though studies have shown that almost all of them work, are in school, or are taking care of family members. Removal of recipients for failed reporting this year will cease.


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