Judge shreds Kentucky for trying to take away everyone’s health care

Kentucky Republicans, led by their arch-conservative governor, Matt Bevin, keep trying to take people’s Medicaid coverage away by imposing onerous work requirements — and the courts keep saying no.

Last year, a federal court struck down Kentucky’s GOP-backed law that would have required most Medicaid recipients work at least 20 hours per week, a move that could kick more than 95,000 low-income people off of their health care.

So Kentucky — along with the Trump administration, which approved the plan — tried again. And they lost. Again.

When the federal district court ruled against Kentucky last year, it did so on the grounds that the state hadn’t bothered to consider whether making Medicaid recipients work was compatible with Medicaid’s goal of providing health care to vulnerable people. Rather than significantly change its program, however, Kentucky got the Department of Health and Human Services (HHS) to reapprove it.

Kentucky’s new argument as to why the work requirement should stand is novel, to say the least. They admit that, yes, their work requirement plan might kick over 95,000 people off of Medicaid, but 450,000 people would get kicked off Medicaid if Kentucky ends its Medicaid expansion entirely — which is what Republican governor Matt Bevin has threatened to do.

The judge did not like this argument at all. He pointed out that, by this logic, it would be adequate if the experimental Medicaid program (which both requires people to work and to pay monthly premiums for health care coverage) covered even one person — because that would be “greater than the number if there were no Medicaid at all.”

During oral arguments on the case, the judge gave Kentucky and the HHS a chance to provide a “limiting principle” — to say that their proposed policy did have some logical limits. They couldn’t even do that. The judge noted in his ruling that this logic, or lack thereof, would mean that a state could decide it didn’t wish to cover pregnant women or people who are blind, or throw all but 100 people off Medicaid.

The Secretary of HHS, Alex Azar, got slammed by the court as well. HHS asserted that people would just transition off of Medicaid to private coverage, and therefore not all 95,000 people would lose health care. The judge said he’d already heard this same argument in the earlier lawsuit, and that HHS had “cited no research or evidence that this would happen, nor did it make concrete estimates of how many beneficiaries might make that transition.”

Finally, the judge cast doubt on HHS’ ability to fix the problem at all, given that when the department was previously told to address the issue of loss of coverage, Azar instead had a “second failure to adequately consider one of Medicaid’s central objectives.”

With that, the judge struck down the work requirements entirely and immediately, and sent the law back to HHS for yet another go-round.

This isn’t just a loss for Kentucky Republicans. It’s a loss for the Trump administration, which backs these sorts of work requirements precisely because they result in thousands of people losing coverage.

For now at least, thanks to the courts, Kentucky citizens can keep their health care.

Published with permission of The American Independent Foundation.