Medicaid work requirements in Kentucky, Arkansas blocked by federal judge

A federal judge blocked Arkansas and Kentucky from imposing work requirements on Medicaid recipients, saying the Trump administration needs to go back and examine whether the conditions are consistent with the program’s main mission.

The ruling is a setback for President Trump, who’s tried to rein in President Obama’s vast expansion of the federal-state insurance program for the poor by setting up guardrails that nudge people off the government dole.

His administration is encouraging states to condition benefits on seeking a job, volunteering or otherwise engaging in the community. But opponents have sued, saying the rules are confusing, counterproductive and flout Medicaid’s half-century mission of simply providing health insurance.

U.S. District Judge Court Judge James E. Boasberg blocked Kentucky from implementing its rules for the second time, while throwing roadblocks in front of Arkansas, which imposed its rules early on and has nudged at least 18,000 people out of coverage.

He said the administration’s decision to approve of Arkansas’ requirement “is arbitrary and capricious because it did not address — despite receiving substantial comments on the matter — whether and how the project would implicate the ’core’ objective of Medicaid: the provision of medical coverage to the needy,” Judge Boasberg wrote.

He led off his opinion with anecdotes about people who’d been working and relied on the program, but were kicked off the rolls because they had trouble reporting 80 hours of work per month, notably due to poor internet access.

Capitol Hill Democrats who’d cried foul over Mr. Trump’s work requirements hailed the decision.

“Medicaid was created as a way for vulnerable Americans to get the care they need, not as a testing ground for ideological, anti-health care experiments,” Sen. Ron Wyden, Oregon Democrat, said. “There will be more work in the days ahead to ensure this ruling stands, but now it is clear that this cruel scheme is on the wrong side of the law.”

The Health and Human Services Department has approved work requirements in eight states, though several more are awaiting approval through the Medicaid waiver process.

It’s staunchly defended the requirements, saying work gives people purpose and actually makes them healthier in the long run.