As of yesterday, Medicaid enrollees and consumer health advocates in Arkansas and Kentucky can officially breathe a sigh of relief. Medicaid work reporting requirements were struck down in both states in the cases of Stewart v. Azar and Gresham v. Azar and, therefore, will be halted in Arkansas and won’t be implemented in Kentucky. Judge James E. Boasberg of the D.C. District Court issued an opinion concluding that the HHS Secretary’s decision to approve work requirements in both states was unjustified “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.” For Kentucky Medicaid enrollees, this decision means they won’t be subject to an ineffective and burdensome reporting requirement that was slated to begin in July. For the over 18,000 individuals in Arkansas who lost Medicaid as a result of the reporting requirement, the court decision means this harmful barrier that stood between them and the health care they need will no longer be in place.
Judge Boasberg’s decision also confirmed what the health advocacy community has long known about Medicaid – that it’s a critical program whose purpose is to provide health coverage to millions of individuals, including children, older adults, individuals with disabilities and low-income parents and families. Rules and policies that only serve as administrative hoops for individuals to jump through do not further this purpose because they only stand in the way of health care access and coverage. The fact that 18,000 individuals in Arkansas lost Medicaid in 2018 while only a small fraction reported newly working as a result of the work reporting requirements speaks for itself. Work reporting requirements only hinder, rather than further, Medicaid’s goals of providing health coverage to those who need it most.
While today’s decision will likely be appealed by the federal government, for the time being, work reporting requirements in both states will not be implemented for the remainder of 2019, a tremendous victory for health advocates and stakeholders who voiced opposition to this harmful change, as well as those who initiated the litigation to stop it. Additionally, this decision serves as a warning to other states currently contemplating them in their state legislative sessions, and sets an important precedent for the other six states which have received approval to impose work reporting requirements (Arizona, Indiana, Michigan, New Hampshire, Ohio and Wisconsin) as well as the seven states which are awaiting federal approval (Alabama, Mississippi, Oklahoma, South Dakota, Tennessee, Utah and Virginia). Halting this harmful setback means Medicaid can continue providing the multitude of benefits it already confers on millions of individuals across the country.