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Kentucky Gov. Matt Bevin (left) and President Trump. Photo: Mark Wilson/Getty Images

Republican governors and the Trump administration both suffered a serious setback on Friday when a federal judge blocked Kentucky's version of Medicaid work requirements from taking effect.

Why it matters: Work requirements are among the most significant changes the Trump administration has made so far in health policy. The new rules are also a critical part of conservatives' effort to frame Medicaid as a welfare program.

The catch: That's exactly why the policy ran into trouble in court.

Driving the news: U.S. District Judge James Boasberg ruled Friday that the Health and Human Services Department had not sufficiently demonstrated that work requirements would further Medicaid's goals as a health care program.

  • That's a requirement of the waiver process under which HHS has been approving work requirements.
  • "The Secretary never once mentions the estimated 95,000 people who would lose coverage, which gives the Court little reason to think that he seriously grappled with the bottomline impact on healthcare," Boasberg wrote.

What to watch: Boasberg's ruling only applies to Kentucky, not the other states where HHS has approved work requirements. But this will not be the last legal challenge, and if more judges follow Boasberg's lead, the administration's effort to redefine Medicaid could end up backfiring.

  • In Kentucky, Gov. Matt Bevin has said he will back out of the Medicaid expansion entirely if he ultimately loses this litigation.
  • In the meantime, Boasberg gave HHS another chance to come back with a stronger justification for the new rules.

Meanwhile:

  • Maine Gov. Paul LePage has, unsurprisingly, vetoed the latest effort to implement the state's expansion, which voters approved last year.
  • Republicans in Idaho are hoping to formally cement the party's opposition to an upcoming ballot initiative on Medicaid expansion.
  • The Tennesseean asks why Tennessee has not joined the expansion ranks.

Go deeper

Updated 8 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Health: Most vulnerable Americans aren't getting enough vaccine information — Fauci says Trump administration's lack of facts on COVID "very likely" cost lives.
  2. Politics: Biden unveils "wartime" COVID strategyBiden's COVID-19 bubble.
  3. Vaccine: Florida requiring proof of residency to get vaccine — CDC extends interval between vaccine doses for exceptional cases.
  4. World: Hong Kong to put tens of thousands on lockdown as cases surge.
  5. Sports: 2021 Tokyo Olympics hang in the balance.
  6. 🎧 Podcast: Carbon Health's CEO on unsticking the vaccine bottleneck.

Trump impeachment trial to start week of Feb. 8, Schumer says

Senate Majority Leader Chuck Schumer. Photo: The Washington Post via Getty

The Senate will begin former President Trump's impeachment trial the week of Feb. 8, Majority Leader Chuck Schumer announced Friday on the Senate floor.

The state of play: Schumer announced the schedule after reaching an agreement with Republicans. The House will transmit the article of impeachment against the former president late Monday.

9 hours ago - Health

CDC extends interval between COVID vaccine doses for exceptional cases

Photo: Joseph Prezioso/AFP via Getty

Patients can space out the two doses of the coronavirus vaccine by up to six weeks if it’s "not feasible" to follow the shorter recommended window, according to updated guidance from the Centers for Disease and Control and Prevention.

Driving the news: With the prospect of vaccine shortages and a low likelihood that supply will expand before April, the latest changes could provide a path to vaccinate more Americans — a top priority for President Biden.

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