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A date has been set for oral arguments in a legal battle over whether work requirements should be imposed on some Medicaid recipients in Kentucky and Arkansas.

Oral arguments on the Kentucky HEALTH and Arkansas Works programs are set for Oct. 11 at the U.S. Court of Appeals for the District of Columbia Circuit.

Both the Trump and Bevin administrations are challenging a March decision by U.S. District Court Judge James Boasberg to vacate the federal approval of Kentucky HEALTH, the state’s planned overhaul of Medicaid.

Boasberg rejected the Arkansas program on the same day as Kentucky’s, and just last month, he struck down New Hampshire’s Medicaid work requirements, saying, “We have all seen this movie before,” according to news reports.

Kentucky’s Section 1115 demonstration project would require “able-bodied” Medicaid recipients to complete and report 80 hours a month of work or other “community engagement,” such as volunteering or job training. Other proposed features include monthly premiums for some.

Gov. Matt Bevin, who is running for reelection, has threatened to end Medicaid expansion if Kentucky HEALTH is not allowed to go forward. Meanwhile, he continues to promote the community engagement requirements on the campaign trail.

When people opt not to work, “it creates a sense of entitlement … and it sets a bad example for next generations of children who see their parents not going to work and working the system,” Bevin said at a recent Kentucky Chamber of Commerce Business Summit. “… You should not be expected to subsidize that choice.”

But Medicaid recipients say U.S. Health and Human Services Secretary Alex Azar overstepped his authority in approving Kentucky and Arkansas’ programs, jeopardizing “the health and welfare of tens of thousands of people.”

A recently published study by researchers from the University of Pennsylvania, Philadelphia, and elsewhere concluded that about 48,000 Kentuckians would have had to take on new activities to meet community engagement hours if they had gone into effect in July 2018.

Medicaid recipients in Kentucky have been successful twice in sidelining Kentucky HEALTH, which was reapproved by the Trump administration last November after an initial legal challenge.

“This case challenges the efforts of the Executive Branch to bypass the legislative process and act unilaterally to ‘comprehensively transform’ Medicaid, a cornerstone of the social safety net that currently provides health insurance coverage to more than 65 million low-income individuals,” the beneficiaries asserted in court documents.

But proponents say Medicaid waivers like Kentucky’s could put beneficiaries on the path to self-sufficiency, although about 18,000 people lost coverage after the Arkansas work requirements started being rolled out last year.

“If the demonstrations prove successful, they will help able-bodied adults transition to financial independence and commercial coverage, thus preserving scarce Medicaid resources for other needy persons,” the federal government says in court documents. “In addition, they will improve the health of Medicaid beneficiaries, which reduces program expenses and likewise conserves scarce resources.”

 

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Darla Carter
Darla Carter is a hometown girl who recently joined the staff of Insider Louisville to mostly cover health. She previously served as a longtime health and fitness writer for The Courier-Journal, where she also worked for the Metro, Neighborhoods and Features departments. Prior to that, the award-winning journalist wrote for newspapers elsewhere in Kentucky and Tennessee, covering a range of topics, from education to courts. She's a graduate of Western Kentucky University, where she studied journalism and philosophy, and is the proud mom of two young children.