The Independent View: Judge Blocks Work Requirements for Medicaid in Kentucky

A Plan pushed by Kentucky Gov. Matt Bevin (R) to impose Work Requirements on some of his State’s Medicaid Enrollees Violates Federal Law and can’t continue, a U.S. District Judge ruled Friday.

The First-in-the-Nnation Policy would apply to Adults without Disabilities, with some Exceptions, and would require that Medicaid Enrollees be Employed, Searching for a Job, Enrolled in School, or Participating in “Community Engagement” Activities like Volunteering in order to Qualify for Coverage.

The Kentucky Plan also seeks to impose Monthly premiums on some Medicaid Beneficiaries. Dubbed Kentucky HEALTH, the Program was Scheduled to take effect on Sunday, July 1st, 2018.

In his Decision, U.S. District Judge James Boasberg ruled that the Secretary of the U.S. Department of Health and Human Services (HHS) Overstepped the Bounds of the Federal Laws governing Medicaid when HHS Approved Kentucky’s Application for Work Requirements and other Changes to the Program.
“Although the secretary is afforded significant deference in his approval of pilot projects like Kentucky’s, his discretion does not insulate him entirely from judicial review. Such review reveals that the secretary never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid,” Boasberg wrote. “This signal omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky’s project and remand the matter to HHS for further review.”

Boasberg, who sits on the U.S. District Court for the District of Columbia, heard Oral Arguments in the Case on June 15th. While his Ruling applies only to Kentucky’s Medicaid program, it could set a Precedent for Legal Challenges to Work Requirements in other States.

Bevin has threatened to End the Entire Medicaid Expansion Implemented by his Predecessor, then-Gov. Steve Beshear (D), under the Affordable Care Act if the Work Requirements and other Elements of Bevin’s Plan aren’t put in place. Ending Medicaid Expansion would Reverse the Dramatic Decline in Kentucky’s Uninsured Rate and cause more than 460,000 People to Lose Coverage. But that Drastic Step isn’t imminent because the Governor also said he would Exhaust his Legal Options first. In other words, the Judge’s Decision is likely to be Appealed.

Unlike other Government Benefits such as Food and Cash Assistance, Medicaid has never before come with Work Requirements. That began to Shift in January when President Trump’s Administration invited States to Apply for Federal Approval to make Unprecedented Changes to the Program.

The Plaintiffs in the Kentucky Lawsuit include 15 Medicaid Beneficiaries, the National Health Law Program, the Kentucky Equal Justice Center, and the Southern Poverty Law Center. They argued that Work Requirements are Incompatible with Medicaid’s Statutory Mandate to provide Coverage and Improve Health.

The Trump Administration, the Defendant in the Lawsuit, maintains that Promoting Work also Promotes Health, making Work Requirements an Appropriate use of Medicaid, an assertion largely Unsupported by the Available Evidence.