Jan 16, 2019

Kentucky's Medicaid work requirements are back in court

Kentucky woman with sign that says save medicare saves lives

Protestors in Kentucky who want the Affordable Care Act. Photo: Bill Pugliano/Getty Images

Kentucky’s plan to impose Medicaid work requirements is being re-challenged in court, after it was re-approved by the Trump administration this past November.

Flashback: Kentucky was the first state to win approval for Medicaid work requirements last year.

  • A federal judge stopped those rules from taking effect, saying the Health and Human Services Department hadn’t made a compelling enough case that work requirements align with Medicaid’s stated purpose.
  • In response, HHS reopened the window for public comments on Kentucky’s proposal, then quickly re-approved basically the same policy.

A new class-action lawsuit filed on behalf of 16 Kentuckians says the re-approval is still illegal.

  • It accuses HHS of "working to effectively rewrite the Medicaid statute, ignoring congressional restrictions, overturning a half century of administrative practice, and threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country."

The big picture: Medicaid work requirements are arguably the most substantively significant piece of health policy the Trump administration has implemented.

  • The policy would substantially curb enrollment — Kentucky estimates more than 90,000 people would lose their coverage there — and help redefine a health care program as a form of welfare.

Go deeper: Kentucky's health care microcosm

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