Federal judge blocks Kentucky Medicaid work requirements

A federal judge just struck a blow to the Trump administration’s cruel plot to gut Medicaid

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In his ruling Wednesday, Judge James Boasberg of the U.S. District Court for the District of Columbia sided with plaintiffs who argued that work requirements do not further the Medicaid program's statutory goal, which is to provide access to health care for people with low incomes.

The US Department of Health and Human Services (HHS) approved Kentucky's work requirement plan in January 2018, but the plan has yet to go into effect. "We emphatically disagree because a healthcare program like Medicaid, by its very nature, must take into account whether it improves people's health", said Adam Meier, secretary of Kentucky's Cabinet for Health and Family Services.

Arkansas was the state that had already implemented a work requirement, and had already kicked 18,000 people off Medicaid between September and December of previous year for non-compliance (or actually, for the most part, failure to promptly report compliance).

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Instead, he wrote that HHS approval of the Arkansas requirement was "arbitrary and capricious because it did not address ...whether and how the project would implicate the "core" objective of Medicaid: the provision of medical coverage to the needy".

Boasberg found that HHS failed to adequately consider what effect the policy would have on coverage, so he vacated HHS' approval of each state's Medicaid waiver, sent the matter back to HHS for further proceedings, and ordered the parties to appear for an April 10 status hearing.

Kentucky was the first state to begin implementing work requirements last January. The ruling likely eliminates similar plans in other states which might be on the table. Republicans in these states are now intent on chipping away at this progress, and work requirements are one way the Trump administration is encouraging them to do it. A federal judge on Wednesday threw out the work rules. The Centers for Medicare & Medicaid Services reapproved the Kentucky's request in November, and the state planned to begin the program later this year. She has claimed that denying low-income people health coverage is actually good for them, insisting that "it is not compassionate to trap people on government programs or create greater dependency on public assistance". Maine's new Democratic governor terminated that state's work requirement waiver.

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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. In states like Virginia and Utah, work requirements were added to persuade Republican lawmakers to go along with expansion. This is the second time Boasberg has blocked Kentucky's work requirement waiver, which has not yet been implemented. 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.

"Today's ruling is a positive step towards preserving access to health care for the millions of cancer patients, survivors and individuals at risk of developing the disease who rely on Medicaid for health care coverage", said Lisa Lacasse, president of the American Cancer Society Cancer Action Network in a press statement on Wednesday.

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