Fifteen Medicaid beneficiaries in Kentucky are suing the Trump administration in federal court for approving a waiver that would require some beneficiaries of the program to work.
The plaintiffs are being represented by the National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center.
“Through imposition of premiums and cost sharing, ‘lockouts,’ benefits cuts, and a work requirement, the waiver will radically reshape Medicaid in a manner that, by the state’s own admission, will result in substantial reductions in coverage,” the groups wrote in an executive summary about the lawsuit.
In the complaint, the groups wrote that federal officials violated Medicaid law by adding the work requirement provision, which they argue can be changed only through Congress. Medicaid waivers, they wrote, are intended to expand access to coverage or improve health.
They argued that states are not allowed to impose additional requirements on the program. Under Obamacare, states were allowed to expand coverage to people of a specific income level, regardless of work status.
The complaint also said the Administrative Procedure Act was violated, which requires presidents “take care that the laws be faithfully executed.”
The plaintiffs say they could be harmed under the changes because they will have to abide by reporting requirements and face difficult barriers like inadequate transportation or lack of access to a computer.
“The change will harm Kentuckians across the state – housekeepers and custodians, ministers and morticians, car repairmen, students, and musicians – who need a range or health services, including check-ups, diabetes treatment, mental health services, blood pressure monitoring and treatment and vision and dental care,” the lawsuit said.
The lawsuit was filed in U.S. District Court for the District of Columbia. The plaintiffs are requesting the court block the requirements from going into effect during the court battle.
The Kentucky waiver is expected to result in 95,000 fewer people being enrolled in Medicaid. It applies only to adults who are working age and not disabled, provides exemptions for caregivers, pregnant women, older adults and children, as well as people who are undergoing treatment for addiction. Proponents of the program say Medicaid could help people find employment so that they no longer need to be covered by the program, which is offered to people making roughly $16,000 a year or less. Opponents say the paperwork and administrative burdens associated with the requirements will result in people becoming uninsured.
The Trump administration on Jan. 11 published guidelines for states to refer to as they consider implementing Medicaid work, volunteer or education requirements as a condition for some people to be enrolled in the program. The administration approved Kentucky’s waiver the following day. At least nine other states are considering similar waivers.
Kentucky officials have said they intend for some of the requirements to begin in July. Republican Gov. Mark Bevin has threatened to discontinue Medicaid expansion if faced with a lawsuit, and signed an executive order stating those intentions. The expansion covers nearly half a million Kentuckians.
Under Obamacare’s Medicaid expansion, in which Kentucky participated, the federal government paid for the first three years of expansion but states gradually pick up a maximum of 10 percent in of costs by 2020, starting at 5 percent of costs in 2017. Kentucky officials cited the costs associated with the share of expanding coverage as one of the reasons they wanted to implement the waiver.
