Federal judge blocks Kentucky Medicaid work requirements

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In separate opinions, US District Judge James Boasberg found that disruptions to the Medicaid programs, Arkansas Works and Kentucky HEALTH, were not taken lightly but did not outweigh the claims of individual plantiffs who had lost coverage in Arkansas or who might lose it in Kentucky, where the program has been on hold. "Additionally, individuals who have not complied with the work and community engagement requirement from January to March 2019 can not be removed from the program for noncompliance going forward".

The requirements generally apply to people who qualified for Medicaid under the expanded program that was part of the Affordable Care Act, enacted during the Obama administration.

A federal judge blocked Medicaid work requirements in two states on Wednesday, dealing a blow to one of the Trump administration's marquee efforts to push the poor toward self-sufficiency. They mean that low-income people in Kentucky and Arkansas will maintain their health insurance coverage - coverage that enables them to live, work and participate as fully as they can in their communities. He said the work requirement would help move some adults off the program so the state has enough money to help other enrollees.

Several other Republican-controlled states are now seeking approval for similar work requirement programs. It sort of went with their idea that people shouldn't really be getting government benefits if they can work.

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CMS Administrator Seema Verma has made Medicaid work requirements a centerpiece of the administration's health policy. A federal judge on Wednesday threw out the work rules. The Medicaid Act sets strict guidelines about how the program can be run, but the Department of Health and Human Services can approve what are called "Section 1115" waivers if a state has a custom-designed plan that would promote health and coverage beyond what traditional Medicaid does. They should have to work for them. Arkansans must reapply if they want coverage.

Bevin said the state will appeal the ruling. In states like Virginia and Utah, work requirements were added to persuade Republican lawmakers to go along with expansion.

In Kentucky, expansion supporters fear Bevin will react to the ruling by either trying to end the expansion or by cutting benefits, which he did temporarily after Judge Boasberg first blocked the waiver previous year.

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. 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. Under the rules in Kentucky and Arkansas, recipients also can fulfill the requirements if they volunteer or continue their education.

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"Arkansas might use the time while the program is paused to consider whether and how to better educate persons about the requirements and how to satisfy them", he wrote.

Eight states have had their requests approved, though not all have put their programs in place, according to the nonpartisan Kaiser Family Foundation.

Arkansas began implementing work requirements last June.

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