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Federal Judge Rules Against Kentucky's Medicaid Work Requirements

A federal judge ruled against Kentucky's Medicaid work requirements on Friday.

U.S. District Judge James E. Boasberg stated that the Trump administration acted in an "arbitrary and capricious" manner when it gave the OK to Kentucky to become the first state in the nation to require that low-income people work or participate in community service in order to qualify for Medicaid, according to The Washington Post.

The change had been a priority for Governor Matt Bevin, who worked to end Kentucky's kynect program that was part of the Medicaid expansion under the Patient Protection & Affordable Care Act, also known as Obamacare.

The newly launched Kentucky HEALTH program, which Bevin announced in May, and which was supposed to start in Campbell County and then Kenton County before moving elsewhere in the state, will now be reviewed again by the U.S. Department of Health & Human Services.

President Trump's administration gave the OK to Kentucky in January to proceed with its plans. Indiana, Arkansas, and New Hampshire were later granted permission to include work requirements in their state programs.

In Kentucky, the National Health Law Program, Kentucky Equal Justice Center, and the Southern Poverty Law Center all sued to stop Bevin's plan.

Bevin did not comment on Friday.

The governor's newly appointed secretary at the Cabinet for Health & Family Services, Adam Meier, of Fort Thomas, issued a statement. "The Court’s ruling invalidates Kentucky HEALTH on a very narrow basis," said Meier, who was previously a city councilman in Fort Thomas and also deputy chief of staff to Bevin. "The Court concluded that the HHS Secretary simply failed to consider the impact of Kentucky HEALTH on Medicaid coverage. While we disagree with the Court’s ruling, which delays implementation of Kentucky HEALTH, we look forward to working with CMS to quickly resolve the single issue raised by the Court so that we can move forward with Kentucky HEALTH. Without prompt implementation of Kentucky HEALTH, we will have no choice but to make significant benefit reductions.

"Kentucky HEALTH is an innovative, thoughtfully crafted program that will strengthen Medicaid by engaging beneficiaries in their own health outcomes.  Able-bodied Kentuckians deserve to have a stake in their health and will benefit from the dignity that comes from career training, education, and volunteer opportunities that are available as part of Kentucky HEALTH’s community engagement program.  We will fight to preserve these opportunities for our citizens so that we can proceed with the only viable path forward for expanded Medicaid in Kentucky."

The decision was celebrated in other corners.

"Health care is a human right. Eligible Kentuckians who require care should be afforded access to Medicaid without impediments. Further, Governor Bevin has repeatedly said he will end Medicaid expansion for the nearly 500,000 Kentuckians who have benefited should the court find work requirements unconstitutional," said Secretary of State Alison Lundergan Grimes, who is viewed as a possible Democratic challenger to the Republican Bevin in 2019. "I call on Governor Bevin to stop holding the health and wellbeing of Kentuckians hostage and fulfill his duty to all of our Commonwealth’s citizens."

“Kentucky Voices for Health and our partners applaud the court’s decision to support Kentuckians on Medicaid by refusing to create additional barriers,” said Emily Beauregard, executive director for Kentucky Voices for Health. “Kentucky’s Medicaid population consists of hardworking parents, caregivers, and other community members who need access to healthcare. During the waiver comment period, over 3,000 Kentuckians voiced their opinion on the devastating effects of this policy, and the court heard those voices.”
“We all know that Kentucky is caught in the midst of an opioid epidemic, and while the waiver talked about providing treatment for Kentuckians with substance use disorders, the many barriers and requirements made it more unlikely that people with addictions would seek much needed treatment," said Sheila Schuster, executive director for Advocacy Action Network. "I am relieved that the court recognized the potential harm in this policy.”
"Research consistently shows that access to healthcare helps vulnerable people with housing stability,” said Adrienne Bush, executive director of the Homeless and Housing Coalition of Kentucky. “From people experiencing chronic homelessness to families trying to achieve homeownership, access to healthcare through Medicaid and housing stability are inextricably linked. People living in the margins do not need additional barriers to opportunity, and we are glad the federal court recognizes this."
“The Judge's ruling recognizes that Medicaid demonstration waivers must adhere to a purpose--to improve coverage and care,” said Rich Seckel, executive director of the Kentucky Equal Justice Center. Of Governor Bevin’s threat to “unexpand” Medicaid entirely were the court to rule in the plaintiffs' favor, Seckel said, “We've always believed that this should be decided based on law rather than threat. That's what the plaintiffs sought. The governor knows how to appeal if he disagrees; that would be the wiser path for him."
"People with mental illness are not always going to fall into the medically frail category,” said Marcie Timmerman, executive director of Mental Health America of Kentucky. “I'm relieved to know Kentuckians will not be subject to unintended negative consequences from this waiver experiment."
“This ruling recognizes the critical role Medicaid plays in providing health care coverage in Kentucky," said Dustin Pugel, policy analyst for the Kentucky Center for Economic Policy. "This coverage is not only good for the health of 1.4 million Kentuckians, it’s good for our economy, too. Removing these radical and unnecessary barriers to coverage was the right call.”

"Today’s ruling inevitably means further court wrangling and continued uncertainty for Kentucky’s families. Health coverage is so vital, and it’s tough on families who are left with more questions than answers as the case moves to the next court setting," said Dr. Terry Brooks of Kentucky Youth Advocates. "Regardless of the final outcome of the case and regardless of attendant decisions, Kentucky Youth Advocates is going to keep asking the same – and singular – question: Is it good for kids?”

“Reason has prevailed once again against Gov. Bevin and the Republican majority’s attack on everyday Kentuckians,” Kentucky Democratic Party Chair Ben Self said. “Bevin’s work requirements for Medicaid recipients was not only immoral but goes against who our leaders should stand up for and who we are as Kentuckians.”

-Michael Monks, editor & publisher

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