Kentucky Plan for Medicaid Work Requirement Struck Down Again

President Trump with Seema Verma (left), Administrator of the Centers for Medicare and Medicaid Services (Image)

On Wednesday, United States District Judge James E. Boasberg ruled against a proposal in Kentucky to impose work requirements on Medicaid recipients. The plan would require citizens of the state to have a job, be in training for a job, or volunteer in their community before becoming eligible to receive Medicaid. This was the second time the state has seen its Medicaid proposal blocked by Boasberg.

Early last year, the Trump administration announced that it would allow states to enforce work requirements on Medicaid recipients. The statement claimed these work requirements would “increase [recipients’] sense of purpose, build a healthy lifestyle, and further the positive physical and mental health benefits associated with work.”

Kentucky was one of the first states to work on imposing work requirements on its Medicaid recipients following Trump’s declaration.

However, Boasberg — an Obama-era appointee — shut down the state’s plan, opining that the proposed work requirements did not consider whether the changes would “help the state furnish medical assistance to its citizens, a central objective of Medicaid.” This sentiment is shared by former President Obama, who did not approve states’ attempts to impose work requirements during his tenure in office.

Seema Verma, a policy consultant appointed by President Trump, says that the requirement helps people “rise out of poverty and government dependence.” Further, she has openly criticized the Obama administration’s opposition to Medicaid work requirements, going so far as to say that “[b]elieving that community engagement requirements do not support or promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the [Obama] administration…those days are over.”

Verma’s position on this issue are shared by a number of Republicans. Senator John Kennedy (R-LA) said of himself and some of his Republican colleagues: “We don’t want to throw people out in the cold, but we want to help them understand the dignity of work.”

According to a 2017 study, 60% of non-elderly adults that receive Medicaid benefits have jobs, and 85% of these adults even work full-time for the full year. Furthermore, of the non-working Medicaid recipients, 81% are either ill or disabled, in school, or taking care of young children in the home.

Altogether, Medicaid is an extremely popular program among the general public; nearly 75% hold a favorable opinion of the program. In addition, 70% of the public supports states’ rights to impose Medicaid work requirements. Among elected representatives, however, work requirements for Medicaid recipients are often supported by Republicans and opposed by Democrats.

Though Judge Boasberg blocked Kentucky’s second attempt at establishing Medicaid work requirements, it is possible that his ruling will be overturned if the case gets handed up to the Supreme Court. Such a ruling would mark a major change in state-sponsored health insurance policy, the magnitude of which has not yet been seen during the course of Trump’s presidency.