Arkansas Urges Appeal to Restore Medicaid Work Rules
Arkansas Urges Appeal to Restore Medicaid Work Rules
Federal judge blocks Kentucky Medicaid work requirements
31 March, 2019, 05:43
A federal judge today tossed out work requirements created by Kentucky and Arkansas for people to receive Medicaid benefits, writing in separate opinions that HHS approval of both programs failed to consider the core goal of Medicaid-to provide healthcare for the needy. The Obama administration refused to approve a lot of these state programs, but the Trump administration really embraced the idea.
Quoting baseball great Yogi Berra, Judge Boasberg wrote: "It's deja vu all over again."He rejected the Justice Department's claim that halting Arkansas' work requirement program would be disruptive".
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 a year ago for non-compliance (or actually, for the most part, failure to promptly report compliance). In January 2018, the Trump administration gave Kentucky permission to require some Medicaid recipients to get a job, go to school or volunteer to keep their benefits.
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 objective, which is to provide access to health care for people with low incomes.
"Judge Boasberg's decision does not change that, and it does not require that the Arkansas Department of Human Services automatically re-enroll any of those individuals in the program". Boasberg granted plaintiffs full relief, agreeing that HHS Secretary did not act reasonably in allowing states to create work requirements for beneficiaries to receive healthcare.
"As long as they hold on to hope that some judge will rule in their favor, states will continue to pursue work requirements", he said. Some 100,000 people could be dropped from the rolls because of the new rules.
KODJAK: Yeah, so the Affordable Care Act expanded who could receive Medicaid, and it offered states money. Orders sending both state waivers back to HHS are expected today.
In the case of Kentucky's waiver, the Trump administration argued that HHS did not have to consider the issue of whether it would cause people to lose coverage because Kentucky's Republican Gov. Matt Bevin had warned that if the waiver was not granted, he would end the state's entire expansion program.
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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.
But advocates for the poor say that Medicaid is a health care program and that work requirements have no place in it. Boasberg did not resolve that core issue.
Arkansas Gov. Asa Hutchinson said he was disappointed with the decision. It was adopted under his Democratic predecessor and provides coverage for 400,000 people.
Boasberg blocked the work requirements in both cases, writing that they were "arbitrary and capricious" because HHS had not properly considered the effects that the work requirements would have on Medicaid recipients.
"Every one of the able-bodied people taking (Medicaid), is taking it right out of the hands, right out of the mouths and right out of the pockets of the people for whom Medicaid was designed", Bevin said.
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.
A new report from The Commonwealth Fund found that work requirements would leave hospitals with lower revenues, higher levels of uncompensated care and, consequently, even tighter operating margins. They had to work 80 hours a month and lost coverage if they failed to comply three months in a calendar year.
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