Policy

‘Undeterred’ Trump Administration to Push Ahead With Medicaid Work Rules

Despite Kentucky setback, Alex Azar says HHS is “fully committed” to work requirements

Health and Human Services Secretary Alex Azar says the administration will continue to litigate the Kentucky case and is “fully committed” to work requirements in the Medicaid program. (Tom Williams/CQ Roll Call file photo)

The Trump administration will continue to approve state Medicaid work requirement proposals, Health and Human Services Secretary Alex Azar said Thursday, despite a federal court recently blocking Kentucky from implementing such rules.

The administration will continue litigating the Kentucky case and is “fully committed” to work requirements in the Medicaid program, Azar said during an address at The Heritage Foundation, a conservative think tank.

“We suffered one blow in a district court in litigation. We are undeterred,” he said. “We will continue to litigate. We will continue to approve plans.”

Azar’s comments come a week after the Centers for Medicare and Medicaid Services reopened public debate over Kentucky’s Medicaid work requirements proposal. A federal district court judge ruled on June 29 that the administration “never adequately considered” how the state’s plan would affect access to medical care for 95,000 low-income Kentuckians.

The new CMS comment period could pave the way for federal officials to reapprove Kentucky’s controversial plan, which law experts say would likely lead to more legal challenges from consumer advocates.

CMS Administrator Seema Verma has also indicated in recent remarks that the administration plans to push forward with Medicaid work requirements.

Consumer advocates argue such work rules lead to people being unfairly kicked off the program because of bureaucratic red tape and the fact that many low-income workers have unpredictable hours, which make it difficult to meet monthly requirements.

The court ruled that Medicaid’s key objective is to provide health coverage to people, said Judy Solomon with the left-leaning Center on Budget and Policy Priorities.

“Policies that take Medicaid away from people who don’t meet work requirements will cause large numbers of people, including many who should remain eligible because they are exempt or already working, to lose coverage,” Solomon said in a statement.

CMS has approved Medicaid work requirements in four states so far — Kentucky, Arkansas, Indiana and New Hampshire — and is considering such proposals from at least seven others. Another half dozen or so states are also pursuing the idea.

The work rule proposals vary but typically require adults who aren’t disabled to work at least 80 hours a month or participate in another activity, such as volunteering or job training. Such plans also usually exempt pregnant women, the medically frail or people in substance abuse treatment, among other vulnerable groups.

Republicans tout work requirements as a way to lift people out of poverty, improve their health and reduce their dependency on government by helping them move on to commercial insurance.

“Work is not a penalty,” Heritage Foundation President Kay Coles James said at Thursday’s event with Azar. “It is amazing to me that some perceive it that way, and I am so particularly grateful that you’re recognizing that even in communities where unemployment rates are such that work may be hard to find, that there’s ample opportunity to volunteer, to give back something to the community.”

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