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Trump administration appeals rulings that blocked Medicaid work requirements

April 10, 2019 at 4:24 p.m. EDT
Elizabeth Cloinger is one of 18,000 people who have lost Medicaid coverage under the Arkansas Works program. Her wages are low enough to qualify for the health insurance but she didn’t understand that she needed to verify her income with the state. (Michael S. Williamson/The Washington Post)

The Trump administration appealed court rulings Wednesday by a federal judge that blocked federally approved programs in two states to compel some able-bodied people to work to qualify for Medicaid.

The appeals, in cases challenging Kentucky and Arkansas’s Medicaid work requirements, come two weeks after a federal judge in Washington issued opinions that President Trump’s top health aides had been “arbitrary and capricious” in allowing the new rules and failed to consider their effect on vulnerable residents’ access to health insurance.

For Kentucky’s program, which was to have started April 1, the opinion was the second time U.S. District Judge James E. Boasberg had ruled against the “community engagement” rules and sent the state’s plan back to the Department of Health and Human Services to reevaluate.

Federal judge blocks Medicaid work requirements in Kentucky and Arkansas

After the initial ruling, HHS did another review, as the court directed, and reapproved, with no changes, the plan it had previously given Kentucky permission to begin. The appeals, in a single paragraph that does not lay out the administration’s arguments, signify that, rather than going through that process again, Trump’s aides are hoping that a higher court will let the requirements go forward.

The appeals to the U.S. Court of Appeals for the District of Columbia Circuit were filed by Justice Department attorneys on behalf of senior administration health officials who are named in the lawsuits: Alex Azar, the HHS secretary, and Seema Verma, administrator of HHS’s Centers for Medicare and Medicaid Services, the branch of the department that approved the two states’ programs.

A Justice spokeswoman declined to comment on the decision to appeal.

The appeals are part of a series of attempts by the administration to persist with policy changes — largely involving health care, the environment and immigration — that federal courts have blocked.

In January 2018, Verma announced that the administration was receptive to states that wanted to require able-bodied people on Medicaid to work, prepare for work, or do volunteer work for a specified number of hours per month. This idea had floated around a few conservative states years earlier — and was consistently rejected by the Obama administration.

A day after her announcement, her agency approved Kentucky’s plan. It was to have begun last summer, but was blocked by Boasberg’s first ruling.

Last June, Arkansas Works, that state’s plan for the part of Medicaid it expanded under the Affordable Care Act, became the first to take effect.

A job-scarce town struggles with Arkansas’s first-in-nation Medicaid work rules

The first recipients were cut off in September for failing for three months to comply with the rules or to submit proof to the state that they were meeting the requirements. By December, about 18,000 people on Arkansas Works had lost coverage.

In January, young adults in the Arkansas Works program were phased in, and the first of them to miss three months were to have been cut off around now. The day after the judge’s March 27 rulings, Arkansas Gov. Asa Hutchinson (R) said the state would halt the work requirements and urged the Trump administration to appeal.

On Wednesday, Hutchinson praised the Justice Department’s decision and said he understood that the department plans to ask the D.C. circuit for an expedited appeal — a move that the governor said “should put this case in the position to get to the United States Supreme Court, if necessary, in a timely fashion.”

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