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Federal court rejects Trump-approved Medicaid work requirements

The Trump administration has backed Medicaid work requirements in several states. A federal court yesterday smacked down the policy.
A doctor measures the blood pressure of a patient. (Photo by Carsten Koall/Getty)
A doctor measures the blood pressure of a patient.

Last year, with the Trump administration's blessing, Arkansas became the first state to impose work requirements on Medicaid beneficiaries. The result was a predictable disaster.

Republican officials in the state created a hard-to-navigate system for beneficiaries, with onerous reporting requirements, which in some cases actually led people to lose the jobs they already had.

When more than 18,000 low-income Arkansans were dropped from Medicaid, the Trump administration's original position was that these people simply "decided that they didn't want" health care coverage anymore. More recently, HHS Secretary Alex Azar made the case that they lost coverage because they received great jobs in Donald Trump's "booming economy" and no longer needed Medicaid.

It wasn't long before the data suggested Azar was very wrong.

Despite -- or perhaps because of? -- the developments in Arkansas, Republican policymakers in more than a dozen states decided they wanted to impose similar restrictions on Medicaid beneficiaries. In all, eight states have followed in Arkansas' footsteps, each with the Trump administration's encouragement.

Those efforts, however, will now have to wait. The Trump-backed policy isn't just a bad idea; it appears to be at odds with the law, too.

A federal judge on Wednesday threw out Medicaid work requirements in two states, a blow to Republican efforts to profoundly reshape a program that has provided free health insurance to the poorest Americans for more than 50 years.In twin rulings, Judge James E. Boasberg of the Federal District Court for the District of Columbia rejected for a second time Kentucky's attempt to require recipients to work or volunteer as a condition of coverage and blocked a similar rule in Arkansas, which has resulted in more than 18,000 people there losing coverage since last summer.

The full ruling is online here.

At the risk of oversimplifying matters, Boasberg, an Obama appointee, concluded that the purpose of the Medicaid program is to extend health care benefits to low-income Americans. The imposition of burdensome work requirements was in pursuit of a political goal at odds with the purpose of the law.

The judge took the extra step of ordering the states to end implementation of the work requirements immediately. Nevertheless, yesterday's ruling will be appealed.