Federal Judge Tosses Medicaid Work Requirements

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Requiring Medicaid enrollees to work in order to qualify for benefits violates the purpose of the health care program for low-income people, a federal judge ruled Wednesday as he struck down a major health care priority for President Donald Trump’s administration.

Last January, the Trump administration invited states to impose these requirements on Medicaid beneficiaries for the first time. Since then, the federal government has approved work requirements in eight states and is considering applications in seven more.

In two opinions issued Wednesday, Judge James Boasberg of the U.S. District Court for the District of Columbia sided with plaintiffs who argued that work requirements do not further the Medicaid program’s statutory purpose, which is to provide access to health care for people with low incomes.

The rulings have immediate ramifications for the work requirements already approved in Kentucky and Arkansas. The latter state must unwind the work requirements it began enforcing last year, while the former state cannot move forward with its plan, according to the terms of the judge’s decisions.

In states including Kentucky and Arkansas that expanded Medicaid to low-income adults using funding authorized by the Affordable Care Act, benefits are available to people earning up to 133 percent of the federal poverty level, which is about $16,000 a year for a single person and $33,000 for a family of four. In 2012, the Supreme Court ruled that states could opt out of the Medicaid expansion. All but 14 states have decided to participate in the expansion. Medicaid is jointly administered and funded by the federal government and states.

Five states with pending applications for work requirements have not expanded Medicaid, meaning the policy would affect people earning even less.

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