Judge blocks Kentucky's Medicaid work requirement

By Harris Meyer
June 30, 2018 - Modern Healthcare

In a blow to the Trump administration, a federal district judge has invalidated the CMS' approval of Kentucky's unprecedented Medicaid waiver, which includes a work requirement, blocking the July 1 implementation of the program.

Judge James Boasberg of the U.S. District Court in Washington, D.C., held that HHS Secretary Alex Azar's approval of the waiver in January was arbitrary and capricious because it failed to take into account the primary objective of the Medicaid statute, which he said is to furnish medical assistance.

"Although the Secretary is afforded significant deference in his approval of pilot projects like Kentucky's, his discretion does not insulate him entirely from judicial review. Such review reveals that the Secretary never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid. This omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky's project and remand the matter to HHS for further review."

The U.S. Justice Department and HHS had argued that requiring Medicaid beneficiaries to work or participate in "community engagement" activities was within the purposes of the Medicaid statute because that would improve the health and well-being of beneficiaries.

Kentucky GOP Gov. Matt Bevin, who pushed hard for the waiver after first promising to end his state's Medicaid expansion, previously had expressed "absolute confidence that the waiver will prevail against this baseless challenge."