Arguing that lower federal courts erred, Arkansas Attorney General Leslie Rutledge is asking the U.S. Supreme Court to overturn rulings that struck down work requirements for recipients of the Arkansas Medicaid expansion.
The administration of President Donald Trump also is encouraging the high court to weigh in.
Monday, Rutledge petitioned for a writ of certiorari formally asking the court to review the case. The U.S. Department of Justice filed a similar petition that day, asking the court to consider the Arkansas case along with a similar case arising from New Hampshire.
Efforts to revive the work requirements come at a time when the state unemployment rate is 9.5%.
"Arkansas Works' model was designed to encourage able-bodied Arkansans without dependents to transition into the workforce, building a stronger, more resilient connection with their communities," Rutledge said Tuesday in a written statement.
She thanked the Justice Department for "asking the Supreme Court to allow our pilot program to continue as a way to support Arkansans by enabling recipients to obtain employment in exchange for Medicaid benefits and create a sense of accomplishment by improving their health and financial independence."
Gov. Asa Hutchinson, who hosted U.S. Attorney General William Barr at the Governor's Mansion last week, also expressed thanks for the federal assistance.
"I discussed this important appeal with AG Barr and I am grateful the Justice Department agreed to support the petition to the US Supreme Court," the governor said in a written statement. "I made the point that winning this case is critical to provide waivers to the states for managing the Medicaid program effectively."
Under the leadership of then-Gov. Mike Beebe, a Democrat, Arkansas expanded its Medicaid program in 2014 as authorized under the 2010 Patient Protection and Affordable Care Act to cover adults with incomes of up to 138% of the poverty level.
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After his election, Hutchinson, a Republican, urged the Legislature to keep the program in place, later adding work or job-training requirements.
At the time, unemployment rates were falling.
The changes were approved by the Trump administration in March 2018 pursuant to Section 1115 of the Social Security Act, which authorizes waivers from federal Medicaid law that the Health and Human Services secretary determines are "likely to assist in promoting the objectives" of the program.
The requirement, which applied to Arkansans ages 19-49 covered under Arkansas Works, resulted in more than 18,000 people losing their health coverage over a nine-month period.
After Arkansas Medicaid recipients sued, a judicial appointee of President Barack Obama, U.S. District Judge James Boasberg of Washington, D.C., struck down the restrictions.
In a March 27, 2019, ruling, Boasberg found that federal Health and Human Services Secretary Alex Azar exceeded his authority in approving the requirements by failing to consider how they would affect the Medicaid program's goal of providing health coverage to needy people.
On Feb. 14, the U.S. Court of Appeals for the District of Columbia Circuit said federal approval of the plan had been "arbitrary and capricious."
In a unanimous three-judge appellate ruling, written by Senior U.S. Circuit Judge David Sentelle, the court found that in approving the project without considering its effect on Medicaid coverage, the U.S. Department of Health and Human Services violated the Administrative Procedures Act.
Sentelle, appointed by President Ronald Reagan, was joined by Judges Harry Edwards, appointed by President Jimmy Carter, and Cornelia Pillard, appointed by Obama.
One of the attorneys representing the Arkansas Medicaid recipients, Legal Aid of Arkansas' Kevin De Liban, said it would be a mistake to reverse the lower-court ruling.
"Both the district court and the circuit court got it exactly right. Medicaid's for the purpose of providing health insurance to people, and the so-called work requirements did nothing but strip health insurance away," he said Tuesday.
Most of those receiving coverage were already employed, he said. Most of the others were either serving as a caretaker, living with a disability or going to school, he said.
"For our clients, these were termination traps," he said. "Getting rid of the work requirement spared tens of thousands of Arkansans from what was, essentially, sure-fire loss of health insurance."
Information for this article was contributed by Linda Satter of the Arkansas Democrat-Gazette.