Federal judge smacks down Kentucky's work requirements for Medicaid


In a scathing ruling, a federal judge blocked Kentucky's move to strip health care away from as many as 100,000 people.

A federal judge blocked Kentucky's Medicaid work requirement on Friday, dealing a major blow to the Trump administration's backdoor attempt to strip health care away from the poor by imposing arbitrary new rules on Medicaid beneficiaries.

The new work requirement, which was set to go into effect Sunday, would have mandated that most Medicaid recipients show proof they are working at least 20 hours a week in order to remain eligible for the program.

But in a ruling issued Friday afternoon, U.S. District Judge James Boasberg said that the Trump administration had not adequately considered whether requiring Medicaid recipients to work would actually help the program fulfill its purpose of providing health care coverage to vulnerable citizens.

Boasberg called the administration's approval of the program, called Kentucky HEALTH, "arbitrary and capricious."

"The [HHS] Secretary never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid," he said in his ruling. "This signal omission renders his determination arbitrary and capricious."

Boasberg also noted that HHS Secretary Alex Azar failed to mention that 95,000 people could lose coverage under the strict new provision — an oversight that the judge called "glaring."

Work has never been a requirement for receiving assistance through Medicaid, but the Trump administration sought to implement the new mandate to limit the number of people who could qualify for the program — something that Republicans have wanted to do for years.

In January, the Centers for Medicare & Medicaid Services sent a letter to state Medicaid directors, telling them that states could start imposing work requirements for Medicaid recipients.

At least two dozen states immediately moved to implement new rules that would allow them to kick people off Medicaid for failing to meet work requirements that are so strict, even people who are working regularly could lose access to Medicaid.

Kentucky was the first state to have such a system approved. Besides allowing the state to deny Medicaid coverage to any able-bodied adult who cannot provide sufficient proof of employment, the new regulations would have charged premiums to low-income Medicaid recipients and eliminated coverage of dental care, vision care, and over-the-counter medications for many adults.

A short time after Kentucky received approval to enact the new rules, a group of 15 residents filed a lawsuit to stop them from going into effect.

Friday's ruling does exactly that — but it could also have major national implications as Trump and his Republican allies seek to insert similar work requirement provisions into other federal programs for poor Americans, including housing and food assistance programs.

All of these proposals rest on the false assumption that poor people are lazy and don’t want to work, and that government assistance programs reward poverty and reduce the incentive to stop being so poor. In reality, eight in ten non elderly adult Medicaid recipients already work, and the vast majority of those who aren't working are either sick, disabled, or caretakers for a sick or disabled family member.

Despite years of research showing that receiving government benefits has "little if any" impact on employment or work hours — and that imposing work requirements is ineffective — Republicans have continued to wage war on poor Americans and the programs that help them get by.

While the new ruling doesn't put an end to this fight, it does hand a major victory to the 15 plaintiffs — and more importantly, it preserves access to health care for nearly 100,000 people who might have been kicked off Medicaid in the next 48 hours.

Published with permission of The American Independent Foundation.