Payers, Policy

Federal judge blocks Kentucky and Arkansas Medicaid work requirements

While the policy has not yet gone into effect in Kentucky, data from the Arkansas Department of Human Services found that more than 18,000 people in the state have lost coverage due to the work requirements that were first introduced last year. 

In yet another court battle that could have major ramifications for U.S. healthcare policy, a federal judge in Washington, D.C. has blocked the Medicaid work requirements that have been approved by CMS in Kentucky and Arkansas.

U.S. District Judge James Boasberg (a President Obama appointee) had already previously kicked back work requirements in Kentucky to HHS because of what he considered a lack of consideration on whether the policy “would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

He used a similar logic to invalidate the work requirements in his recent decision.

“Given a second failure to adequately consider one of Medicaid’s central objectives … the court has some question about HHS’ ability to cure the defects in the approval,” he wrote in his decision.

“As Opening Day arrives, the Court finds its guiding principle in Yogi Berra’s aphorism, ‘It’s déjà vu all over again,’ he added.

While the policy has not yet gone into effect in Kentucky, data from the Arkansas Department of Human Services found that more than 18,000 people in the state have lost coverage due to the work requirements that were first introduced last year.

Work requirements in six other states have been approved by CMS through the Section 1115 waiver process, which allows states to test new approaches to delivering or paying for care under Medicaid. Seven other states have also submitted their own waiver requests.

The decision by Judge Boasberg comes only days after the Trump Administration reversed course and chose to support a decision invalidating the Affordable Care Act, which includes Medicaid expansion provisions.

The invalidation of the work requirements in Kentucky and Arkansas could lead to problems in states where work requirements were instituted as part of a pre-requisite of Medicaid expansion.

“We will continue to defend our efforts to give states greater flexibility to help low-income Americans rise out of poverty,” CMS Administrator Seema Verma said in a statement after the court decision.

“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.”

While Medicaid work requirements have been positioned by the Trump Administration as a way to incentivize able-bodied individuals to contribute to the workforce, the Los Angeles Times recently reported that state programs lack a plan to collect data that could help asses the success or failure of the policy in real-world situations.

Photo: fstop123, Getty Images

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