Medicaid Ruling Protects Health Care for Kentuckians, All Americans

By Renato Rocha

Last week, a federal District Court dealt a blow to the Trump Administration and states trying to take away Medicaid from people who can’t meet new work requirements.

At issue was Kentucky’s Medicaid waiver request, which the Trump Administration approved. Judge James E. Boasberg ruled that the administration’s approval was “arbitrary and capricious,” because it didn’t consider the impact on affordable health coverage in spite of numerous comments. The judge vacated the waiver’s approval, sending it back to the U.S. Department of Health and Human Services (HHS) for further review. 

As a result of the ruling, Kentuckians will continue to have access to Medicaid. According to state estimates, the waiver would have kicked 95,000 people off the program. The legal challenge was brought by 15 plaintiffs, described as “housekeepers and custodians, ministers and morticians, car repairmen, retired workers, students, church administrators, bank tellers, caregivers, and musicians.” These Kentuckians are meeting their health care needs through Medicaid and would have suffered serious harm from the waiver.

For instance, plaintiff Ronnie Maurice Stewart is 62 years old; retired; and suffering from diabetes, arthritis, and high blood pressure. Medicaid has allowed him to treat these conditions. It also covered eye surgery that prevented him from going blind. Under the waiver, Mr. Stewart would lose health coverage if he doesn’t meet new work requirements. Because of his health and age, he’s no longer able to work when it requires him to stand all day.

Mr. Stewart’s case isn’t unique. Hundreds of thousands of Kentuckians would be subject to policies that would take health coverage away if individuals don’t meet new work requirements. A national study from the Kaiser Family Foundation estimates that as many as 50 percent of Medicaid recipients who are non-exempt and non-working would lose coverage under work requirements. If work requirements are adopted nationwide, Kaiser estimates that most of the people who would lose coverage are already working or qualify for an exemption. They would simply lose coverage due to burdensome paperwork.

This ruling isn’t the end of the fight over Medicaid. The administration and Kentucky will likely appeal Judge Boasberg’s ruling. The state may also ask for approval to proceed while the appeal is pending.

The decision doesn’t directly affect other states that received or applied for waivers. However, it sends a strong message that HHS doesn’t have unlimited authority to grant waivers without prioritizing Medicaid’s goal: providing affordable health care to low-income communities. That includes people who received Medicaid as a result of expansion under the Affordable Care Act.

As the battle continues in court, CLASP isn’t letting up. We’ll use our expertise on income and work supports and low-wage employment to oppose harmful proposals to Medicaid, including by commenting on any new waivers. It’s time for states and the administration to recognize that taking away people’s health care, food, and housing is always a bad idea. For the sake of our nation’s future, we have to meet people’s basic needs while creating pathways to economic security.