SPLC argues in court against Medicaid work requirements

Ronnie Stewart retired from his job as a medical assistant after his arthritis, diabetes and high blood pressure made it too difficult for him to stay on his feet all day.

Since then, Medicaid has covered his health issues. But that coverage is now in jeopardy. New rules from the Trump administration and the state of Kentucky will require Stewart, 62, to either go back to work until he is 64 or lose his health insurance.

Stewart is one of 15 plaintiffs in a lawsuit the SPLC and other advocacy groups filed against the Trump administration earlier this year, challenging its approval of sweeping changes to Medicaid that will endanger the health care of tens of thousands of low-income people in Kentucky. 

Today, the SPLC and its partners urged a federal judge to block the Medicaid changes because they violate the U.S. Department of Health and Human Services’ (HHS’) authority under the Social Security Act.

“Donald Trump made promises to protect Medicaid when he was campaigning, but as president, he is not doing that,” Stewart said. “I’m not alone in this predicament. There are many Kentuckians in the same boat, and we need the judge to reverse this harmful attack on Medicaid. We need to start promoting the common good by supporting Medicaid and other programs that benefit low-income and working Americans, rather than catering to special interests.”

The lawsuit marked the first legal challenge to the Trump administration over changes to the Medicaid program that could strip health insurance from millions of low-income people across the country. The suit challenges the administration’s policy of allowing states to seek “waivers” of federal Medicaid rules – essentially permitting them to place onerous new conditions on the poor, such as work requirements.

“HHS failed to assess the impact of the waiver on low-income people,’’ said Samuel Brooke, the SPLC’s deputy legal director. “Many people enrolled in Medicaid are struggling to make it in low-wage jobs. Under this waiver, many of them will be forced off Medicaid, and will likely be unable to afford private health coverage. The Trump administration’s approval of this waiver was a critical misstep that should not be allowed to stand.”

The National Health Law Program (NHELP) and the Kentucky Equal Justice Center (KEJC) joined the SPLC in filing the lawsuit in January, and in making today’s arguments before the judge. The law firm Jenner & Block is counsel to NHELP in the case.

Ian Gershengorn, partner with Jenner & Block, argued that HHS violated federal law when it approved the waiver request from Kentucky health officials.

“Unlike some other public assistance programs, Medicaid is not a jobs-training program, and the administration does not have the authority to turn it into one,” said Gershengorn, who is also a member of the NHELP board. “The rule of law requires that the president adhere to and uphold federal law, not subvert it.”

KEJC Senior Attorney Anne Marie Regan said that ever since Kentucky expanded Medicaid under the Affordable Care Act in 2014, the state has seen the percentage of its uninsured residents go from being one of the highest in the country to one of the lowest. 

“We see our clients and low-income people all across the Commonwealth finally getting the preventive services and medical treatment they need,” Regan said. “Medicaid coverage enables people to work. This approval got it exactly backwards by conditioning health coverage on work.”