Judge strikes down New Hampshire Medicaid work requirements program

A federal judge dealt another legal blow to the Trump administration's efforts to encourage Medicaid work requirements. AndreyPopov/iStock/Getty Images Plus/Getty Images

A federal judge struck down New Hampshire’s work requirements for Medicaid, dealing another legal blow to the Trump administration.

The decision issued Monday by U.S. District Judge James Boasberg comes after federal courts struck down similar work requirement programs in Kentucky and Arkansas. Boasberg was the same judge who struck down both of those programs for similar reasons.

Boasberg’s opinion, issued a week after hearing oral arguments in the case, said that HHS’ approval of work requirements for New Hampshire meant that a significant number of people would drop from Medicaid’s rolls. He also chided HHS for not fully considering the loss of enrollment when approving the waiver for New Hampshire.

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He also chided HHS for not fully considering the loss of enrollment when approving the waiver for New Hampshire. Boasberg cited a projection from the Kaiser Family Foundation that pegged enrollment losses of between 2,600 and 7,500.

HHS’ approvals were “arbitrary and capricious” because they didn’t fully consider the full impact on coverage, nor did the agency present an estimate for the number of people that could lose coverage, Boasberg said.

RELATED: States likely to stay the course on Medicaid work requirements despite judge’s ruling, experts say

The judge, who was appointed by former President Obama, also cited coverage losses from Arkansas’ work requirement program, where nearly 17,000 people lost coverage.

Arkansas’ program only required able-bodied Medicaid beneficiaries to complete 80 hours a month of activities ranging from education, job training to work. New Hampshire’s program required 100 hours a month, leading to projections that the state’s program “would lead to more coverage loss than Arkansas’s program,” Boasberg’s opinion read.

HHS argued last week that any coverage loss is outweighed by other goals such as financial independence, health and saving states money in their Medicaid program.

But Boasberg found the agency’s arguments wanting. For example, he said that financial independence isn’t an objective of the law that created Medicaid and HHS didn’t weigh the benefits of any self-sufficiency versus the loss of coverage. He also argued that he doubts work requirements will lead to lower costs for states because of a rise in uncompensated care due to the loss of coverage.

The Centers for Medicare & Medicaid Services didn't say whether the administration will appeal the ruling, but that it will continue to "defend our efforts to give states greater flexibility to help low-income Americans rise out of poverty."

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