States vow to press on with Medicaid work requirements

Arkansas and Kentucky officials are vowing to continue the fight to implement work requirements in their Medicaid programs despite a US District Court judge striking down the mandates.

Asa Hutchinson, the Republican governor of Arkansas, said Thursday that he asked the Trump administration to appeal the judge’s decision and ask for an expedited decision.

“I remain fully committed to a work requirement and we are in this for the long-haul because we believe it is the right policy,” Hutchinson said at a news conference. “There should be consequences if people don’t exercise responsibility.”

US District Court Judge James Boasberg on Wednesday voided the administration’s approvals of requests by the two states to mandate that low-income people work for benefits and kicked the matter back to the Department of Health & Human Services for further review. In both cases, the approvals did not address how the requests would align with Medicaid’s core objective of providing coverage to the needy, the judge said.

However, Boasberg also said it’s not impossible for the agency to justify its approvals, but it has yet to do so.

The Centers for Medicare & Medicaid Services, which has granted work requirement requests from nine states and is considering several more, said it will continue to defend its approvals.

Arkansas was the first state to mandate that its Medicaid enrollees work, volunteer or go through job training at least 80 hours a month. Some 18,000 residents have lost coverage since the program began in June because they failed to report sufficient hours, according to state data. While they are eligible to re-enroll this year, fewer than 2,000 have done so.

Hutchinson maintained that the program is a success, saying that 88% of enrollees are in compliance. Most don’t have to report monthly because they work, have dependent children, are medically frail or are otherwise exempt.

Fewer than 1,750 people reported meeting the requirement in February, but the majority did so by saying they already met the work mandate in the food stamp program, according to the latest state data.

The state’s mandate has been halted because of the judge’s ruling, and no one else will lose coverage at this time, Hutchinson said.

A spokeswoman for Kentucky Gov. Matt Bevin, who has threatened to end Medicaid expansion if the state can’t implement work requirements, did not return requests for comment. But he told The Associated Press that he plans to appeal, calling Boasberg a “rogue judge.”

The governor briefly ended dental and vision benefits for nearly 500,000 recipients after Boasberg initially vacated the federal approval in June before restoring them amid a public outcry.

A Kentucky official said he believes the state could win on appeal.

“In Kentucky, we want more than to simply give someone a Medicaid card they can put in their wallet — we want a program that focuses on actually improving health outcomes,” said Adam Meier, secretary of the Cabinet for Health and Family Services. “And that is what Kentucky HEALTH was designed to do. Kentucky HEALTH is precisely in line with the objectives of the Medicaid program and squarely within the authority of the HHS Secretary to approve.”

Consumer advocates, however, argue that work requirements hurt people’s ability to rise out of poverty.

“Taking people’s health care away does not allow you to be able to work more,” said Kelly Whitener, associate professor at Georgetown’s Center for Children and Families. “It has the opposite effect.”