The ruling Wednesday by U.S. District Judge James Boasberg blocks Kentucky from implementing the work requirements and Arkansas from continuing is program. One Arkansas plaintiff, 40-year-old Adrian McGonigal, understood he had to show proof of work and did so once, despite a lack of access and facility with computers. In Arkansas, Gov. Asa Hutchinson (R) said he would address the decision in a news conference Thursday, the Arkansas Democrat-Gazette reported. He further criticized Kentucky, which argued that their work requirement does further the mission of expanding health coverage because Gov. Matt Bevin meant to cancel Medicaid expansion entirely if he didn't get his way: "The Court can not concur that ... states are so armed to refashion the program Congress designed in any way they choose". "Arkansas", he wrote, "might use the time while the program is paused to consider whether and how to better educate persons about the requirements and how to satisfy them".
The Trump administration said it would press on despite the ruling, but did not specify its next steps. "Coverage matters, plain and simple", said Jane Perkins, legal director at the National Health Law Program, one of the groups involved in both suits.
"The judge illogically concluded that Medicaid is all about paying for healthcare for as many people as possible without regard to whether this coverage actually makes people healthier", the agency said in a written statement.
Boasberg blocked the work requirements in both cases, writing that they were "arbitrary and capricious" because HHS had not properly considered the effects that the work requirements would have on Medicaid recipients. Politically, of course, work requirents are relatively popular, and tend to put progressives in the hard position of defending a failure to work by allegedly able-bodied beneficiaries, even though studies have shown that almost all of them work, are in school, or are taking care of family members.
"We will continue to defend our efforts to give states greater flexibility to help low-income Americans rise out of poverty", she said. "We believe, as have numerous past administrations, that states are the laboratories of democracy and we will vigorously support their innovative, state-driven efforts to develop and test reforms that will advance the objectives of the Medicaid program".
HHS had already acted. But that law also allowed states to ask the federal government for permission to do Medicaid their own way. Verma says she believes work is important to improving the health and well-being of Medicaid recipients.
Eight states have had their requests approved, though not all have put their programs in place, according to the nonpartisan Kaiser Family Foundation. The whole objective of Medicaid under the law is to give medical care to low-income people.
A new report from The Commonwealth Fund found that work requirements would leave hospitals with lower revenues, higher levels of uncompensated care and, consequently, even tighter operating margins. And so it promoted this idea state to state, and now it's looking like it's going to be hard to implement.
Boasberg was nominated to the federal bench by Obama. Arkansas itself has said that 18,000 people just previous year were disenrolled from its Medicaid program after these work requirements went into effect. There are seven similar state work requirements on deck to be considered by CMS, and the rulings have the potential to affect all.