Medicaid Work Requirements Struck Down

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A federal judge blocked Medicaid work requirements in two states on Wednesday, dealing a blow to one of the Trump administration's marquee efforts to push the poor toward self-sufficiency.

A federal judge has once again blocked new rules for Kentucky's Medicaid program that would require those seeking to keep their health benefits to either get a job, go to school or volunteer.

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. 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.

Consumer groups, including the National Health Law Program, sued the administration over the work requirement, saying it was contradictory to Medicaid's objective of providing the poor with access to health care.

Kentucky was the first state to begin implementing work requirements last January. They never went into effect because of Boasberg's ruling last summer. The Obama administration refused to approve a lot of these state programs, but the Trump administration really embraced the idea.

In his earlier, June 29 opinion in the Kentucky case, Boasberg alsoheld that federal officials who approved the new rules had been "arbitrary and capricious", neglecting to consider adequately whether the requirements "would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid". So far, about 18,000 people have lost coverage for failing to meet the rules, or failing to report to the state that they complied. They mean that low-income people in Kentucky and Arkansas will maintain their health insurance coverage - coverage that enables them to live, work, and participate as fully as they can in their communities.

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The question of work requirements has emerged as a bright line in the ideological debate over the role and nature of the nation's social safety net. "That provision of the Act does not turn the comprehensive Medicaid program into a buffet for states", he wrote. He said on Twitter last night that anyone encountering problems in reapplying for Medicaid coverage can call Legal Aid of Arkansas at 800-967-9224.

Six other states have had work requirement waivers approved by the administration and seven states have applications pending. The Affordable Care Act originally required states to expand Medicaid, but a Supreme Court ruling allowed states to decide whether they wanted to or not. "I have not yet had the opportunity to review the opinion in its entirety, but I plan to do so this evening and provide further comment tomorrow morning on the future of the Arkansas Works work requirement".

He used similar language in his ruling on Kentucky.

Boasberg said Kentucky and the federal government essentially are arguing that Medicaid coverage is promoted by an experimental program that leaves any additional individual on the Medicaid rolls. Verma says she believes work is important to improving the health and well-being of Medicaid recipients.

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 previous year.

April 1 is a significant date in both states: Under the Arkansas Works rules, the clock starts over each January, when people removed from the program can reapply and a new three-month countdown begins.