The Trump administration announced Tuesday evening that it had reapproved a waiver that would require certain beneficiaries in Kentucky work as a condition of receiving healthcare coverage from Medicaid, five months after the initial plan was struck down by a judge.
In the time since, the Centers for Medicare and Medicaid Services opened a public comment period which allowed for feedback from various outside groups.
Johnathan Monroe, CMS spokesman, said that agency officials had “worked diligently to analyze and consider the comments received” and determined the program would “promote the objectives of Medicaid.”
The approval letter to Kentucky said that one of the purposes of Medicaid is to advance the health and wellness of the person receiving medical coverage or to help people become independent from the program.
Typically the Medicaid program in states is funded fully by the federal and state governments, but the change in Kentucky will add premiums for certain enrollees. It also will give people more access to treatment for addiction and provide $1,000 to help pay for out-of-pocket medical expenses.
The program is expected to reduce Medicaid spending by $2 billion over five years, $300 million of which will come from state funds, according to the governor’s office.
Derrick Ramsey, Kentucky’s education and workforce development cabinet secretary, said in a statement that the program “creates an opportunity for Kentuckians to actively engage in their health as well as gain new skills to help transition them successfully into Kentucky’s workforce.”
Republicans and Democrats disagree over the purpose of Medicaid. Under Obamacare, states were allowed to expand it to people making less than roughly $17,000 a year, regardless of whether they worked or had a disability.
Kentucky was the first state to seek a change to the program under the Trump administration that required certain people enrolled in Medicaid to work, volunteer, or take classes as a condition of staying enrolled. The provision contains multiple exemptions, including for people who are caregivers or people undergoing treatment for addiction, but critics have said that the requirements are onerous and will leave people uninsured.
They point to developments that later occurred in Arkansas, in which 12,000 people were removed from Medicaid rolls in the state following the work requirement going into effect. Arkansas is facing its own lawsuit over the requirements, but the Trump administration has continued to encourage states to develop similar programs.
It was not immediately clear whether the organizations that had sued over the Kentucky program would do so again. The National Health Law Program, the Kentucky Equal Justice Center, and the Southern Poverty Law Center represented the plaintiffs in the original lawsuit.
U.S. District Judge James Boasberg, an appointee of former President Barack Obama, determined in June that the Trump administration “never adequately considered” whether the Kentucky program, known a Kentucky HEALTH, “would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.”
He stated in his ruling that the Trump administration’s decision to add work requirements was “arbitrary and capricious” because it did not consider whether it would help bring medical care to citizens, which is one of the goals of the program under Obamacare. He noted that studies showed 95,000 people would be rolled off of Medicaid in Kentucky if the plan were to go into effect.
