A federal judge on Wednesday threw out Medicaid work requirements in two states, in “a blow to Republican efforts to profoundly reshape a program that has provided free health insurance to the poorest Americans for more than 50 years, as The New York Times reported on March 27. “In twin rulings, Judge James E. Boasberg of the Federal District Court for the District of Columbia rejected for a second time Kentucky’s attempt to require recipients to work or volunteer as a condition of coverage and blocked a similar rule in Arkansas, which has resulted in more than 18,000 people there losing coverage since last summer,” the Times’s Abby Goodnough reported.
“So far,” Goodnough’s report noted, “the Trump administration has allowed eight states to begin requiring many of their Medicaid recipients to work, volunteer or train for a job to be eligible for benefits. Seven other states are seeking permission from the Department of Health and Human Services to impose similar rules.”
As the Associated Press’s Ricardo Alonso-Zaldivar noted, in a report published in The Washington Post, “U.S. District Judge James E. Boasberg in Washington, D.C., blocked work requirements for low-income people in two states — Arkansas and Kentucky. He found that the states’ requirements pose numerous obstacles to getting health care that have gone unresolved by federal and state officials. Boasberg sent the federal Health and Human Services Department back to the drawing board,” Alonso-Zaldivar wrote. “But he stopped short of deciding the central question of whether work requirements are incompatible with Medicaid, a federal-state program that traditionally allows states broad leeway to set benefits and eligibility.”
And a report by Rachana Pradhan in POLITICO quoted from Judge Boasberg’s ruling, in which Boasberg wrote, “The Court cannot concur that the Medicaid Act leaves the [HHS] Secretary so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose.” Boasberg, an appointee of President Barack Obama, was named to the U.S. District Court for the District of Columbia in 2011.
Seema Verma, Administrator of the federal Centers for Medicare and Medicaid Services (CMS), responded to the ruling in a statement released in a tweet and published on the CMS.gov website. Verma wrote that “We will continue our efforts to give states greater flexibility to help low income Americans rise out of poverty. We believe, as have numerous past Administrations,” Verma wrote, “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.
The AP’s Alonso-Zaldivar wrote that “The Trump administration said it would press on despite the ruling, but did not specify its next steps. Work requirements are already in effect in Arkansas, but Kentucky’s program has been on hold because of lawsuits,” he added. “Both states want ‘able-bodied’ adults who get health insurance through the Affordable Care Act’s Medicaid expansion to work, study, volunteer, or participate in ‘community engagement’ activities.” Meanwhile, “About 6 in 10 adults on Medicaid already work in low-wage jobs, according to the nonpartisan Kaiser Family Foundation. Most of those not working cite reasons such as poor health, caring for an elder or child, or going to school.”
Alonso-Zaldivar also reported that “Kentucky Gov. Matt Bevin said his state would appeal. Bevin, a Republican, has threatened to end Kentucky’s Medicaid expansion covering more than 400,000 people if work requirements are ultimately struck down.” And he quoted Gov. Bevin as stating that “We have one guy in Washington who thinks he owns Kentucky,” apparently referring to the judge. “We’re right, and we’ll be right in the end. And one guy can gum up the works if he wants, for a while, but this, too, shall pass.” Meanwhile, Arkansas Gov. Asa Hutchinson, Alonso-Zaldivar reported, “said he was disappointed by the decision and would publicly address it Thursday.”
