Kentucky Appeals Ruling On Medicaid Work Requirements

Apr 15, 2019

Credit Natalia Merzlyakova / 123rf Stock Photo

Kentucky Gov. Matt Bevin's administration will team with the Trump White House to challenge a federal judge's ruling that blocked work requirements for some low-income people on Medicaid, state officials said.

The state has filed a notice of appeal with a federal appeals court, and Kentucky's challenge of last month's ruling will be consolidated with the Trump administration's appeal, state officials said.

The challenges stem from a ruling by Judge James Boasberg in Washington, D.C., that blocked requirements for "able bodied" adults in Kentucky and Arkansas under which Medicaid recipients either had to work, study, volunteer, or perform other "community engagement" activities.

The Justice Department filed notice appealing to the U.S. Court of Appeals for the District of Columbia Circuit. Arkansas also appealed. The Arkansas requirements were already in effect, while in Kentucky they're a top priority for Bevin, a Republican running for re-election this year. The work requirements apply to hundreds of thousands of low-income people in both states who gained health insurance under the Affordable Care Act's Medicaid expansion.

It was the second time Boasberg had rejected Kentucky's Medicaid waiver plan.

In announcing Kentucky's appeal, state Health and Family Services Secretary Adam Meier predicted the Bevin administration will ultimately prevail in implementing the Medicaid rules.

"Although the district court made many errors, worst among them was its unprecedented conclusion that Medicaid does not care about improving people's health," he said in a statement. "We look forward to making our case to the D.C. Circuit and later to the Supreme Court, if necessary."

Boasberg found that the states' work requirements pose numerous obstacles to getting health care that have gone unresolved by federal and state officials. He also questioned whether the state programs were fulfilling Medicaid's core mission of providing medical assistance.

Medicaid is a joint federal and state health care program for the poor and disabled.

Former President Barack Obama's signature health care law gave states the option of expanding Medicaid coverage to able-bodied adults. Under former Democratic Gov. Steve Beshear, Kentucky was among states that did so. It allowed more than 400,000 people to get health benefits, many for the first time. But that was a lot more people than state officials had expected, increasing the state's costs. Bevin has been trying to change the program since he was elected governor in 2015.

In January 2018, the Trump administration gave Kentucky permission to require some Medicaid recipients to get a job, go to school or volunteer to keep their benefits. The state also planned to impose small monthly premiums from those Medicaid recipients to mimic private insurance plans.

Sixteen Kentucky residents sued to block those rules, with the help of advocacy groups.

Bevin said immediately after Boasberg's ruling last month that Kentucky would appeal.

"Every one of the able-bodied people taking (Medicaid), is taking it right out of the hands, right out of the mouths and right out of the pockets of the people for whom Medicaid was designed," Bevin said at the time. "We are going to stay the course and no one rogue judge in Washington, D.C., is going to dictate what the people of Kentucky do to develop our workforce, to develop our people and to make Kentucky the best version of itself."

The state's Medicaid expansion looms as a big issue in this year's race for governor. Democrats vying for the chance to challenge Bevin have sharply criticized the governor's effort to impose the new Medicaid rules.