Case hastened on Medicaid work rules in Arkansas, Kentucky

A federal appeals court on Friday agreed to expedite its consideration of a judge's rulings that struck down Medicaid work requirements in Arkansas and Kentucky.

The order by a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit granted a request by Arkansas and President Donald Trump's administration, which argued that the rulings by U.S. District Judge James Boasberg of Washington, D.C., disrupted demonstration projects in the two states and created uncertainty about whether work requirements that have been approved in other states also will be thrown out.

"Good news!" Gov. Asa Hutchinson tweeted after the order was issued. "It is good to have the support of the President" and Department of Justice, which represents the administration in the case.

Hutchinson spokesman J.R. Davis said the ruling "helps us put this in front of the D.C. [appeals] court as well as the Supreme Court, if necessary, in a timely fashion."

Kevin De Liban, an attorney for Jonesboro-based Legal Aid of Arkansas, which is helping to represent the plaintiffs in Arkansas' case, said the order is "just setting a schedule for the parties" and not a setback or indication "one way or another how the court feels about a particular issue."

"We're prepared to present our clients' cases whenever the court desires," he said.

Boasberg on March 27 found that the Trump administration, in approving work requirements in Kentucky and Arkansas, violated the law governing Medicaid by failing to consider the effect such requirements would have on the program's goal of providing health coverage to needy people.

Arkansas' requirement, which took effect in June, resulted in 18,164 enrollees losing coverage. Boasberg's ruling preserved coverage for an additional 5,492 enrollees who did not meet the work requirement for January and February and had not yet met it for March when the ruling was issued.

Kentucky's requirement had been scheduled to go into effect this month.

Under Friday's order by Appeals Court Judges Patricia Millett, David Tatel and Cornelia Pillard, final briefs in the two cases will be due Aug. 1, and oral arguments will be held in October.

The schedule differs slightly from the one proposed by the Trump administration, which would have made final briefs due July 30 and oral arguments "the first week after the summer recess."

The plaintiffs in the cases had argued against expedited consideration, saying the cases don't meet the criteria for speedy review spelled out in the appeals court's procedures handbook.

According to the handbook, such requests are granted "very rarely" and only when a delay would "cause irreparable injury" or when "the public generally, or in which persons not before the Court, have an unusual interest in prompt disposition. The reasons must be strongly compelling."

The order on Friday didn't explain the panel's reasoning in granting the request.

Boasberg's rulings stemmed from lawsuits filed in the two states by several Medicaid recipients who were subject to the requirements.

Federal officials have argued that such requirements promote the financial sustainability of Medicaid by prodding enrollees to find jobs and move off the program. They also argue that people who work tend to be healthier than those who are unemployed.

Boasberg's rulings said that the U.S. Department of Health and Human Services didn't weigh those potential benefits against the harm that kicking people off Medicaid for noncompliance would cause to their health and the program's goal of providing health coverage.

To meet Arkansas' requirement, the first ever implemented for a state Medicaid program, enrollees had to spend 80 hours a month on work or other approved activities, unless they qualified for an exemption, and report what they did using a state website or over the phone.

Those who failed to meet the requirement for three months during a year were kicked off the program and barred from re-enrolling for the rest of the year.

The requirement applied to enrollees in Arkansas Works, which covers people who became eligible for Medicaid when the state expanded it in 2014 to cover people with incomes of up to 138 percent of the poverty level.

This year, the income cutoff is $17,236 for an individual or $35,535 for a family of four. More than 240,000 Arkansans were covered by the program as of April 1.

According to the San Francisco-based Kaiser Family Foundation, a health policy research organization, seven other states also have received federal approval to add work requirements to their Medicaid programs, including requirements that have taken effect in New Hampshire and Indiana.

Six other states have applied for approval to add similar requirements to their programs.

Metro on 04/20/2019

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