Child Health

Victory for families: Judge blocks Medicaid work requirements

March 28, 2019 | National

Yesterday U.S. District Judge James Boasberg ruled against the Trump Administration’s approval of Medicaid waivers in Kentucky and Arkansas that included work requirements and other changes that would result in thousands losing their Medicaid coverage.

Medicaid is a powerful anti-poverty tool that helps struggling parents make ends meet through access to health coverage that allows them to provide and care for their families. Judge Boasberg was clear that central to his decision was the administration’s failure to consider how many Medicaid beneficiaries would lose coverage under the states’ proposals to require proof of employment to receive Medicaid benefits. He deemed the administration’s approval of these proposals “arbitrary and capricious” and said that the work requirements must be halted immediately in both states.

Arkansas’ Medicaid work requirement—which took effect last July and has led to 18,000 people already losing coverage—would have resulted in even more beneficiaries being kicked off on April 1. Kentucky had not yet implemented their work requirement, but it posed a threat to thousands of people in the state who rely on Medicaid. While children were not subject to the work requirement in either state, families with children were, and we know that when parents and other caregivers lose Medicaid, their children are harmed as well.

While yesterday’s ruling was a victory for low-income families who get health coverage through Medicaid, the Judge’s decision is narrow and does not rule on the question of whether the Secretary of Health and Human Services has the authority to allow states to impose work requirements as a condition of Medicaid eligibility. It also did not require the administration to suspend or withdraw any of the other approvals of work requirements that have already been granted to other states, though we certainly hope this decision will prevent other states from moving forward with their proposals. To date, in addition to Arkansas and Kentucky, Arizona, Indiana, Michigan, New Hampshire, Ohio and Wisconsin have also received approval from the Trump Administration to impose work requirements on Medicaid beneficiaries. Nine more states (Alabama, Kansas, Mississippi, Oklahoma, South Carolina, South Dakota, Tennessee, Utah and Virginia) have requested approval for waivers that include work requirements.

The Trump Administration has made clear it will pursue any and all avenues to slash health coverage for needy populations. In light of Judge Boasberg’s ruling, we’ll be keeping a close eye on the states’ and the administration’s next steps.