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Of all the policies the Health and Human Services Department has actually finalized under President Trump, it's hard to think of a more significant rightward turn than the approval of Medicaid work requirements.

Driving the news: Judge James Boasberg is still not having it. He ruled against Kentucky's work requirements yesterday for the second time, citing many of the same reasons from his first opinion — namely, that HHS is not living up to Medicaid's legally defined purpose as a health care program.

  • He noted Kentucky and HHS' acknowledgements that fewer people will have Medicaid coverage as a result of these rules, and also criticized Gov. Matt Bevin for threatening to pull out of the expansion entirely if HHS loses this lawsuit.
  • "The Court cannot concur that the Medicaid Act leaves the Secretary so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose," Boasberg wrote.

Arkansas didn't fare much better, though that case is still earlier in the process than Kentucky's.

  • Boasberg began his Arkansas opinion with the story of a resident who does work, but didn't know he needed to report his compliance with the state's work requirements every month, and therefore lost his Medicaid coverage, got sick, and lost his job.
  • That's a clear sign, the ruling argues, that HHS didn't give sufficient weight to work requirements' burden on Medicaid's objectives as a source of health coverage.

What's next: New Hampshire's work requirements are also being challenged in court.

Go deeper: Medicaid work requirements aren't boosting work in Arkansas

Go deeper

Updated 9 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.

11 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.