Medicaid enrollees sue Trump administration for approving Kentucky waiver

lawsuit and book
A new lawsuit contends that HHS overstepped its authority by approving Kentucky's Medicaid waiver. (Getty/eccolo74)

A group of Kentucky residents has filed a lawsuit seeking to block the state’s newly approved plan to make conservative changes to its Medicaid program.

The suit, filed Wednesday in federal court, contends that the Trump administration overstepped its authority by approving Kentucky’s Medicaid waiver—the first in the nation to implement work requirements for beneficiaries.

The National Health Law Program, Kentucky Equal Justice Center and the Southern Poverty Law Center filed the class-action lawsuit on behalf of 15 Kentuckians, who “are all in danger of losing Medicaid coverage” because of the state’s waiver, according to an announcement.

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The lawsuit’s primary argument is that Kentucky’s plan doesn’t comply with Section 1115 of the Social Security Act, which says that Medicaid waivers must implement experimental projects that are consistent with the objectives of the Medicaid Act.

With its work requirements, premium-payment requirements and other provisions—like eliminating transportation to healthcare facilities—Kentucky’s waiver “amounts to a project demonstrating how to destroy a strong health care program,” said National Health Law Program Legal Director Jane Perkins.

“We are calling on the federal court to step in and stop the Trump administration from re-writing the Medicaid Act and stripping Kentuckians of vital healthcare,” she added.

The advocacy groups also criticized Kentucky Gov. Matt Bevin’s recent executive order, which calls for ending the state’s Medicaid expansion if its waiver is blocked.

“The governor’s threat—to punish the 400,000 residents who have received Medicaid under the expansion if a court rules against the Kentucky HEALTH project—is shameless,” said Southern Poverty Law Center Deputy Legal Director Samuel Brooke. “We will not be intimidated.”

Though Kentucky was the first state to have a waiver approved that includes work requirements, it likely won’t be the last. Nine other states have applied for similar waivers, and the Centers for Medicare & Medicaid Services had been clear that it supports such demonstration projects as part of a broader effort to lift Medicaid enrollees out of poverty.

Before approving Kentucky’s waiver, though, CMS issued a set of guidelines that outlines who should be exempt from work requirements—such as pregnant women, the disabled and those who are medically frail. The idea is to help states design programs that both “promote the objectives of the Medicaid program and are consistent with federal statutory requirements,” per CMS.

When asked for a response to the lawsuit’s claims, CMS said it does not comment on pending litigation.