Trump administration appeals judge's decision to block Medicaid work requirements in Kentucky, Arkansas

Wooden gavel and gold legal scale that appear to have sunlight falling on them
The Department of Justice has filed an appeal in the ongoing Medicaid work requirements legal dispute. (Getty Images/William_Potter)

The Trump administration will appeal a judge’s decision to block Medicaid work requirements in two states. 

The Department of Justice on Wednesday filed appeal notices for rulings that rejected such requirements in Kentucky (PDF) and Arkansas (PDF), taking the cases to the District of Columbia Circuit Court. 

District Judge James Boasberg ruled last month that the Centers for Medicare & Medicaid Services failed to consider the central goal of the Medicaid program—to provide coverage to low-income individuals—in approving work requirements in the two states. 


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It’s the second time he rejected the Kentucky HEALTH program on such grounds. CMS reapproved the state’s waiver with few changes. They also once again failed to consider coverage losses in its approval, he said. 

Failing to estimate coverage losses in its second approval was, on its own, “fatal” to that program, Boasberg said. 

RELATED: The 4 biggest Medicaid controversies in 2018 

In approving the waivers, CMS has instead emphasized that work requirements promote health, as they can help people escape poverty. Critics have said, however, that this is not a fair legal argument in their favor, as increasing employment—even if it does make people healthier—is not a goal of Medicaid. 

Arkansas is the only state so far to implement work requirements, and more than 18,000 people were booted in the program in its first six months. Research suggests that few of these beneficiaries left the program because they became employed; the Kaiser Family Foundation estimates that 94% were removed due to an administrative issue

CMS has approved work requirements in several other states, and also gave the OK to a “partial” Medicaid expansion in Utah that could include such requirements. Industry experts said CMS was likely to stick with the requirements an states who were strongly committed were also likely to stay the course, despite Boasberg’s ruling. 

Following Boasberg’s ruling, CMS Administrator Seema Verma said the agency would “continue to defend our efforts to give states greater flexibility” in Medicaid. 

A third lawsuit similarly challenging work requirements in New Hampshire has also been filed. 

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