Medicaid to work programs struck down

Kenny Tucker
March 30, 2019

Washington, D.C. District Court judge James Boasberg struck down work requirements in Kentucky and Arkansas, ruling that the waivers granted by Health and Human Services Secretary Alex Azar were not valid because work requirements do not further the Medicaid Act's mission of improving public health.

Arkansas began implementing work requirements last June. "The Department of Health and Human Services is very committed to work requirements under Medicaid", Pipes said. The Arkansas opinion lays out the strict requirements and the plight of plaintiffs who failed to meet them.

Arkansas itself has said that 18,000 people just previous year were disenrolled from its Medicaid program after these work requirements went into effect.

He used similar language in his ruling on Kentucky. Several other states have requests pending with the Trump administration.

"The law is about providing health care services to low-income individuals and families and under-served populations".

Nationally, some 12 million people are covered by the Medicaid expansion, accepted now by more than 30 states.

Many Republicans have argued for work requirements and other provisions, such as modest premiums, as a condition for agreeing to it.

Last January, the Trump administration invited states to impose these requirements on Medicaid beneficiaries for the first time. That could strip 450,000 people of coverage.

Bevin said Medicaid was meant to provide health coverage for the medically frail, the elderly and the disabled, and is skeptical of offering it with no strings attached to able-bodied, working-age adults who have no dependents.

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"The day of the free lunch is over", Bevin said.

Top Trump administration officials have promoted work requirements, saying they incentivize beneficiaries to lead healthier lives.

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. He said they strike a balance between ensuring health coverage while creating a way for recipients to find a job.

"We will continue to defend our efforts to give states greater flexibility to help low income Americans rise out of poverty", said Seema Verma, the agency's administrator. Arizona's work requirements are scheduled to begin no sooner than next January, she said. The desire to connect Medicaid health benefits to work requirements has always been a goal of conservatives, but the language of Boasberg's opinions relays the reasons why advocates for the poor have been predicting this decision; they have insisted that health benefits and work should not be linked.

He added that the department also didn't address the issues that prompted him to block the Kentucky program in June of past year. Kentucky's plan has not taken effect, after a group of Medicaid enrollees sought and received an injunction to block it. HHS made another try at approving Kentucky's program in November 2018, but this ruling sends the commonwealth and regulators back to the drawing board.

Critics of the requirement said Hutchinson should drop his support for it and instead focus on restoring coverage to the thousands who were kicked off.

"We are gratified by the court's rulings today".

Bevin, who is running for re-election this fall, had threatened to end the Medicaid expansion during his last campaign but backed off that pledge after his victory.

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