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As 1,000 Arkansans removed from Medicaid, Ky. work requirements back in court

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CMS Administrator Seema Verma has defended Medicaid work requirements despite criticism.
Source: AP Images

Another 1,000 people lost Medicaid eligibility in Arkansas in December 2018 due to the state's work requirements policy, bringing the total number of people removed from the health insurance program for low-income Americans in 2018 to over 18,000, according to data from the state's Department of Human Services.

A total of 1,232 people lost coverage at the end of December 2018, according to a Jan. 15 report from the Arkansas DHS. After six months, the work requirements program has resulted in a total of 18,164 Arkansas losing eligibility.

Arkansas in 2018 became the first state to implement a requirement that Medicaid recipients work or participate in other community activities in order to receive the benefits. Those who are removed from the program for not meeting the requirements for three months in a year can re-apply in the next calendar year. The program was expanded from just 30- to 49-year-olds to include 19- to 29-year-olds as of Jan. 1.

Work requirements have been panned by critics who say the new policy is actually hurting Medicaid recipients, not helping them. Centers for Medicare and Medicaid Services Administrator Seema Verma and Arkansas officials have nevertheless defended work requirements. The Arkansas DHS on Dec. 12 announced changes to how work requirements are reported in response to backlash from the program, and the requirements remain subject to a lawsuit in federal court.

Kentucky's waiver back in court

Meanwhile, opponents to a similar work requirements program in Kentucky filed an amended complaint Jan. 14 aiming to block the requirements from going into effect.

The complaint was filed with the U.S. District Court for the District of Columbia by the National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center on behalf of 16 people. The parties argue that CMS and U.S. Department of Health and Human Services Secretary Alex Azar do not have the authority to make significant changes to Medicaid such as work requirements through state waivers, which bypass Congress.

Kentucky's work requirements could lead to as many as 95,000 people losing Medicaid coverage, according to the complaint.

This is the most recent step in ongoing litigation challenging Kentucky's work requirements plan, which was blocked from taking effect by District Judge James Boasberg in 2018. Kentucky's waiver was eventually resubmitted to CMS and re-approved in November 2018.

The amended complaint addresses the resubmitted waver, asserting that the same requirements that were blocked by Boasberg are still intact.

A spokesperson for CMS told S&P Global Market Intelligence in November 2018 that "very little was changed between the two waiver versions."

Seven states have had work requirement waivers approved by CMS and nine have waivers pending, according to the Kaiser Family Foundation, a nonpartisan healthcare nonprofit. Indiana and New Hampshire are scheduled to begin work requirement programs in January.