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Federal judge rules against Medicaid work requirements in Kentucky and Arkansas

A federal judge this week ruled against the Trump administration’s approval of Medicaid waiver projects in Kentucky and Arkansas that include work mandates and other cuts to health coverage.

Yesterday’s rulings are the result of two lawsuits – Gresham v. Azar in Arkansas and Stewart v. Azar in Kentucky – that were filed by the SPLC and its co-counsel. The rulings mean that Kentucky and Arkansas cannot move forward with their Medicaid waiver projects.

This also marks the second time the court has vacated the U.S. Department of Health and Human Services’ approval of the Kentucky project.

“The court reaffirmed the rights of financially insecure individuals to access health care, and concluded once again, that these ‘waivers’ are arbitrary and capricious,” said Samuel Brooke, deputy legal director for the SPLC. “The ruling is a significant rebuff of the Trump administration’s cruel attempts to turn Medicaid, a program designed to ensure access to health care, into a work program.”

Nearly 100,000 residents in Kentucky were likely to lose health care coverage because of these radical, proposed changes to Medicaid, according to the state’s own data. The Medicaid waiver would have required people to comply with work and premium mandates, along with penalties for failing to meet administrative deadlines. It would have also eliminated some previously covered benefits.

In Arkansas, more than 18,000 people have already been cut from health care services under that state’s Medicaid waiver.

The SPLC and the National Health Law Program are co-counsel in both the Kentucky and Arkansas cases. The Kentucky Equal Justice Center is representing people in Kentucky who would be harmed by that state’s project. Legal Aid of Arkansas is representing people who have been harmed by the waiver in that state. The law firm of Jenner & Block is working with the National Health Law Program.

“We are gratified by the court’s rulings today,” National Health Law Program Legal Director Jane Perkins said. “They mean that low-income people in Kentucky and Arkansas will maintain their health insurance coverage – coverage that enables them to live, work, and participate as fully as they can in their communities.

“Coverage matters, plain and simple,” Perkins said. “The court’s decision is clear: Federal agencies must engage in reasoned decision making. That did not happen here. Rather than consider the Medicaid Act’s aim of furnishing medical assistance, (Health and Human Services Secretary Alex M. Azar II) doubled down on his consideration of other aims for Medicaid – including the administration’s stated aim of exploding the (Affordable Care Act’s) Medicaid expansion.”

Kentucky Equal Justice Center Executive Director Rich Seckel also welcomed the rulings.

“Conditioning access to Medicaid on work requirements has always been about blocking low-income individuals and families, many of whom are working numerous jobs or caring for sick family members, from accessing Medicaid,” Seckel said. “Today’s decision reaffirms congressional intent of Medicaid and will save more than 100,000 Kentuckians from losing their vital access to Medicaid.”

Legal Aid of Arkansas Attorney Kevin De Liban said: “This is a great day. Everyone on Arkansas Works can go to bed tonight knowing that tomorrow they’ll be able get the health care they need to work and live a full life.”