States Attempting to Add Changes to Medicaid

Luciano Gonzalez
Staff Writer

News_Luciano_Medicaid_U.S. Army photo by Reese Brown

PC: MaryKent Wolff

A Federal District Court judge has halted an attempt by the state of Kentucky to impose work requirements on people benefiting from Medicaid.

Judge James E. Boasberg of the Federal District Court for the District of Columbia stopped the Medicaid changes for the sake of preventing an estimated 95,000 low-income Kentucky citizens from losing access to healthcare through Medicaid.

According to Boasberg, this would not promote the objectives of the program. At a national level, the Kaiser Family Foundation estimated in late July that a work requirement for access to Medicaid could cause somewhere between 1.4 million people and 4 million people to lose access to healthcare.

The lawsuit that struck down the changes was filed by 15 residents whose access to healthcare was endangered by the work requirement. The reasoning for striking down the work requirement stems from what was seen by Judge Boasberg as a violation of the Administrative Procedure Act.

This is a law which the Supreme Court has ruled ensures that government agencies must support decision-making and policy changes with satisfactory explanations and demonstrate that their actions are reasonable.

Administration officials are undeterred by the Judge’s decision with one prominent example being Alex Azar, the Secretary of Health and Human Services.

Azar claims, “We suffered one blow in a district court in litigation. We are undeterred. We are proceeding forward,” said Azar at a Heritage Foundation speech in July. “We are fully committed to work requirements and community participation requirements in the Medicaid program. We will continue to litigate. We will continue to approve plans.”

Kentucky is only one of the many states that are pursuing work requirements for Medicaid. Federal officials have allowed Arkansas, Indiana and New Hampshire to impose work requirements on Medicaid beneficiaries and other states are seeking permission to do the same. Arizona, Kansas, Maine, Mississippi, Ohio, Utah and Wisconsin are actively pursuing permission to implement the work requirements and it’s likely that other states will soon follow.

In order to implement the requirements, states must get a Medicaid 1115 waiver, a form that the Government Accountability Organization reported was woefully out of date and generally in need of reform at the beginning of the year.

In Arkansas, activists have followed in the footsteps of the 15 people whose lawsuit resulted in the overturning of Kentucky’s work requirements and have sued administration officials in a lawsuit filed by the National Health Law Program, Legal Aid of Arkansas and the Southern Poverty Law Center.

The suit argues not only that work requirements hurt many of the people Medicaid is meant to protect and aid, but that these requirements in Medicaid do not fall within the jurisdiction of the Trump administration. Instead, they are things that Congress must be consulted on in order to be enacted through the proper administrative and legal channels.

Arkansas was the first state to enact such requirements, and one of the criticisms of Arkansas’ implementation of such a policy was that it was only possible to report hours done during the month through an online portal. Arkansas has been deemed to be one of the worst states in the country for broadband internet access.  

This lack of access coupled with data suggesting that only some 844 people in Arkansas of the 16,022 working age adults who weren’t automatically exempt from the work requirements were able to document that they had successfully fulfilled their work requirements, paints a bleak picture for the future of Medicaid access in Arkansas if not for challenges to this work requirement.



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