Pushback Against Kentucky’s Medicaid Work Requirement

A lawsuit is challenging the U.S. federal government’s approval of work requirements for Medicaid recipients in Kentucky, saying they have “effectively rewritten” the federal Medicaid statute to provide insurance to those who cannot afford it.

Allison Hoffman, JD, professor of law at the University of Pennsylvania Law School, told Reuters: “There is… good evidence that [work] requirements add enrollment hurdles that cause people to lose eligibility.”

Kentucky’s waiver requires able-bodied adult Medicaid recipients, with some exceptions, to participate in at least 80 hours per month of “employment activities,” including job training, education, and community service. It also imposes new premiums on recipients and, if they fail to pay, will lock them out of the program for six months.

At least one federal appeals court has struck down a Medicaid waiver under the Administrative Procedure Act, which allows courts to review agency decisions. In 2011, the 9th U.S. Circuit Court of Appeals invalidated a waiver that would have authorized co-pays for Medicaid patients in Arizona.

James Blumstein, LLB, professor of constitutional law and health law at Vanderbilt University Law School, told Reuters he was skeptical that the plaintiffs in the Kentucky case would prevail. He said the Department of Health and Human Services, under which the Centers for Medicare and Medicaid Services operates, has broad authority to determine what is likely to advance Medicaid’s objectives.

Sources: Reuters: January 25, 2018.