Republican lawmakers in recent years have increasingly supported work requirements as a more politically palatable way of thinning out Medicaid recipients than rolling back Medicaid expansion. Arkansas and Kentucky are among 36 states that expanded Medicaid eligibility under the Patient Protection and Affordable Care Act; eight of those states have received approval from the Centers for Medicare and Medicaid Services for a waiver that clears the way for work requirements, Lucia reports.
When Arkansas implemented its work requirements last year, more than 18,000 people lost Medicaid coverage. "Arkansas’ requirements called for most able-bodied adults between 19 and 49 years old to complete 80 hours of work or other approved activities each month," Lucia reports. "These people had to report that they were complying each month mostly using an online portal—a provision that was widely criticized as recipients said they weren’t computer savvy or lacked reliable internet access." Rural residents are less likely to have reliable internet access.
Kentucky's work requirements were similar, mandating that certain Medicaid enrollees spend at least 80 hours a month on a job, community service, substance abuse treatment, or job training. It was to take effect on July 1 last year, but Boasberg blocked it just days before then on the grounds that, like the Arkansas program, it was "arbitrary and capricious," Lucia reports. He noted in his opinion that an estimated 95,000 Kentuckians would lose Medicaid coverage over five years under the new program, and sent it back to the Department for Health and Human Services for reevaluation.
The Trump administration submitted a new plan in November for Kentucky, but Boasberg noted in his latest opinion that the two plans were mostly the same. Rather than follow Boasberg's direction to create a plan that doesn't take coverage away from so many people, "the Secretary doubled down on his consideration of other aims of the Medicaid Act," Boasberg wrote. "Given a second failure to adequately consider one of Medicaid’s central objectives, the Court has some question about HHS’s ability to cure the defects in the approval."
Adam Meier, the secretary of the Cabinet for Health and Family Services in Kentucky, told Lucia that Boasberg was "illogical" in his premise that Medicaid "is all about paying for healthcare for as many people as possible without regard to whether this coverage actually makes people healthier . . . In Kentucky, we want more than to simply give someone a Medicaid card they can put in their wallet," he said, implying that the work requirements would give Medicaid recipients an incentive to get a steady job that would provide medical coverage or beat addiction to make them more employable.
from The Rural Blog https://ift.tt/2WAEXGb Federal judge rejects Medicaid work requirements for Arkansas and Kentucky - Entrepreneur Generations
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