Kentucky lawsuit won't decide the fate of Medicaid work requirements in other states

Michigan's recent decision to expand Medicaid work requirements follows in the footsteps of other states, including Kentucky, Indiana, Arkansas and New Hampshire. (Getty/juststock)

Michigan's recent expansion of Medicaid work requirements—and any potential challenges—won't necessarily hinge on the ongoing legal battle in Kentucky.

Last week, Michigan Gov. Rick Snyder signed into law work or education requirements for many Michiganders who receive Medicaid health coverage, following in the footsteps of Kentucky, Indiana, Arkansas and New Hampshire.

Starting in 2020, able-bodied adults must participate in some kind of workforce engagement averaging 80 hours a month.

“Our Healthy Michigan program has improved the lives of hundreds of thousands of Michiganders, and I’m very proud it has been so successful,” Snyder said in a statement. "I am committed to ensuring the program stays in place and that Michiganders continue to live healthier lives because of it.”

The Trump administration must sign off on the new requirements, but a lawsuit against the governor's administration appears likely, given the court challenge playing out in Kentucky.

Eliot Fishman, senior director of health policy at Families USA, called the bill "destructive and poorly designed," and hinted at future challenges to Michigan's new policy.

"If this waiver goes through, many of those low-income people will lose their health insurance and some will lose much more than that," he said in a statement. "But there remain multiple steps between this decision by a lame-duck governor and an approved, implemented waiver, and we will be working hard to prevent this misguided legislation from taking effect."

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A federal district court is expected to decide on the Kentucky requirements sometime this week, but that decision won't necessarily curtail lawsuits in other states, one healthcare lawyer says.

"Given the diversity of the waiver requests, I anticipate there will be individual complaints filed in each state seeking to implement work requirements and other new Medicaid eligibility requirements," Ross Margulies, an attorney at Foley Hoag, told FierceHealthcare.

He added that the number of hours imposed, what "counts" as work, and who is exempt are unique to each state and would have an enormous bearing in each case.

"While the underlying legal question is similar in each state, given that each waiver is unique, the facts in each case could potentially result in a different outcome," he said.