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Kentucky has followed the Trump administration’s lead by appealing a federal judge’s ruling that recently derailed the Bevin administration’s plans to overhaul Medicaid.

The state filed its notice of appeal Thursday, challenging last month’s decision by U.S. District Judge James Boasberg to strike down the Kentucky HEALTH program — just a few days before it was set to start on April 1.

“We are confident that our appeal in the 1115 Medicaid waiver case ultimately will be successful,” Adam Meier, secretary of the Kentucky Cabinet for Health and Family Services, said via email. “Although the district court made many errors, worst among them was its unprecedented conclusion that Medicaid does not care about improving people’s health. We look forward to making our case to the D.C. Circuit and later to the Supreme Court, if necessary.”

The state won initial approval of Kentucky HEALTH in January 2018 but it was sidelined by a lawsuit brought by more than a dozen Medicaid recipients as well as a January 2019 amended complaint that led to the ruling that’s being appealed.

The Kentucky HEALTH program would have required certain “able-bodied” Medicaid recipients to complete and report 80 hours a month of work or other “community engagement,” such as volunteering or job training, to keep their benefits. Kentucky HEALTH also would have required some individuals to pay premiums and to accrue virtual dollars in a My Rewards account to pay for things like routine dental and vision benefits.

About two weeks ago, Boasberg rejected the Trump administration’s November 2018 approval of Kentucky HEALTH as “arbitrary and capricious” and contrary to the Medicaid Act on March 27 and kicked it back to the U.S. Department of Health and Human Services, as he had done in a similar opinion last year.

The federal government filed a notice of appeal Wednesday and is also appealing a similar decision by Boasberg rejecting a Medicaid demonstration project in Arkansas that has cost thousands of people their Medicaid coverage.

In a motion filed in the U.S. District Court of Appeals for the District of Columbia, the federal government says Boasberg’s rulings rest on errors of law. The U.S. government also requests a speedy decision “so that the projects can go forward and so that, after this Court’s decision, the losing party would be afforded an opportunity to decide whether to ask the Supreme Court to consider the cases before the end of the next Term.”

The federal government, which is proposing a briefing schedule that runs from mid-May to late July, notes that Boasberg’s decisions in the Kentucky and Arkansas cases have caused “significant disruption to the detriment of the States and the federal government, which looks to the results of demonstration projects to determine fruitful courses of action in administering the Medicaid program.”

The federal government also notes that the importance of this legal battle goes beyond Kentucky and Arkansas. The Trump administration has approved similar demonstration projects for Arizona, Indiana, Michigan, New Hampshire, Ohio, Utah and Wisconsin, and some other states have applications that are pending, the motion says.

Boasberg’s decisions “create uncertainty with respect to whether other Medicaid recipients will seek to disrupt similar demonstration projects by other States, where implementation requires advance planning and a significant commitment of resources,” the motion by the federal government says.

The U.S. government also argues that the design of the Kentucky and Arkansas programs is sound and that U.S. Health and Human Services Secretary Alex Azar had the authority to approve them.

This story has been updated with a comment from Adam Meier.

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.