By Phil Galewitz JULY 2,
2018
The fallout from Friday’s federal court ruling that
struck down the Medicaid work requirement in Kentucky was swift.
The decision by Judge
James Boasberg immediately blocked Kentucky from enacting the provision in
Campbell County, which had been set to start Sunday and roll out statewide
later this year.
Within 36 hours, Kentucky
Gov. Matt Bevin, a Republican, eliminated vision
and dental benefits to nearly 500,000 Medicaid enrollees, saying the state
could no longer afford it.
Meanwhile, Arkansas, New
Hampshire and Indiana are moving ahead with the implementation of their versions
of a Medicaid work requirement. It is not clear how or if Boasberg’s ruling
invalidating the Trump administration’s approval of Kentucky’s plan affects
these states.
Arkansas is implementing
its requirement this summer while New Hampshire and Indiana plan to phase in
their rules beginning In January.
Virginia health officials
say they still plan to seek federal permission to enact a work requirement but
it isn’t needed in order to expand Medicaid eligibility on Jan.1.
Virginia lawmakers
approved Medicaid expansion in June with the
condition the state apply for federal permission to include the new mandate.
“We remain focused on the
work necessary to ensure that new health coverage for Virginia adults is
available beginning on January 1, 2019,” Dr. Jennifer Lee, director of the
Virginia Department of Medical Assistance Services, said in a statement.
“Developing a waiver is a separate and ongoing process, as described in the
final state budget.”
Virginia Medicaid is in
discussions with the U.S. Centers for Medicare & Medicaid Services about
its waiver, which has not yet been submitted.
Many Republican lawmakers
in Virginia voted to expand Medicaid only after it was assured new enrollees
would have to work or do volunteer service.
Dr. Scott Garrett, a
Virginia House member from Lynchburg, Va., said he was under the impression the
bill signed in June by Virginia Gov. Ralph Northam, a Democrat, meant the
Medicaid expansion would begin only with a work requirement in place.
“The intent of the
General Assembly … was that you could not do one absent the other,” he said.
Garrett, a Republican,
said he long opposed plans to add 400,000 adults to Medicaid because of cost
concerns. He said requiring these enrollees to work or do volunteer service
would make them healthier and improve their well-being.
Patricia Boozang, senior
managing director for Manatt Health, a consulting firm, said she is not surprised
states are moving ahead with work requirement plans regardless of the court
ruling, which was specific to Kentucky.
She said the decision
would cause the Trump administration to review the pending applications more
closely so they could withstand a judicial review.
The federal court said
Health and Human Services Secretary Alex Azar did not adequately take into
account how many people would lose coverage for the work requirement and did
not prove such a provision would improve enrollees’ health.
“It’s going to be
challenging for them to make the case that health and well-being is going to be
improved by the [work requirement] waiver,” she said.
In Arkansas, some
Medicaid enrollees face a Thursday deadline to register their status — that
they worked, did volunteer service in June or meet one of the state’s many
exemptions.
“The ruling does not have
an immediate effect on Arkansas’ work requirement,” said spokeswoman Marci
Manley.
Advocates for low-income
people are weighing whether to file lawsuits to stop the work requirement in
other states that have won federal approval.
“We
have … partnerships with state legal advocates in these states and are
exploring enforcement and litigation options with them,” said Jane Perkins,
legal director of the National Health Law Program, which filed the suit on
behalf of Medicaid enrollees in Kentucky to block the work requirements.
Phil
Galewitz: pgalewitz@kff.org,
@philgalewitz
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