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Federal Judge Strikes Down Medicaid Work Requirements In Arkansas And Kentucky


A federal judge has said that in Kentucky and Arkansas, the Trump administration cannot put certain work requirements on people who receive Medicaid. That's the health insurance plan for many low-income people. Here to tell us what this means is NPR's health correspondent Alison Kodjak.


CORNISH: And, Alison, first can you give us the lay of the land?

KODJAK: Yeah, so the Affordable Care Act expanded who could receive Medicaid, and it offered states money. Federal government would give states money to provide the insurance to more low-income people. But that law also allowed states to ask the federal government for permission to do Medicaid their own way. And one idea that a lot of states tried to embrace is that people should work or be looking for a job or be doing volunteer work if they want to receive government benefits. The Obama administration refused to approve a lot of these state programs, but the Trump administration really embraced the idea. And as of now, about 15 states have been working on adding work requirements to their Medicaid programs.

CORNISH: What else did the judge say?

KODJAK: So the judge today said that the Department of Health and Human Services and the states, which were Kentucky and Arkansas, didn't consider the impact on people's health care coverage when they put in place these work requirements. The whole purpose of Medicaid under the law is to give medical care to low-income people. So the judge said all these arguments that they - these states and the HHS made that this program has other benefits 'cause it reduces - it brings people out of poverty in the end reduces health care coverage, and that is what is the most important. So he said that because so many people are losing insurance, especially in Arkansas, that that state would have to stop its Medicaid work requirement program right away.

CORNISH: Is there any evidence to back up the judge's skepticism?

KODJAK: Yeah, there is. Arkansas itself has said that 18,000 people just last year were disenrolled from its Medicaid program after these work requirements went into effect. And Kentucky, in its application to add work requirements - those haven't gone into effect yet - said 95,000 people would likely lose insurance. So the judge said basically HHS didn't take these consequences into account when it approved these waivers. I should also note that most people on Medicaid, especially if they are able to work, do work. Or they're in school, or they're taking care of a family member. They just don't make enough money to buy health insurance.

CORNISH: What's significant about this moment?

KODJAK: So this was really a major initiative from the Trump administration. Kentucky had had a regular Medicaid expansion, and they reversed it and tried to add these work requirements. The Trump administration under the Center for Medicare and Medicaid Services really invited states to add these work requirements. It sort of went with their idea that people shouldn't really be getting government benefits if they can work. They should have to work for them. And so it promoted this idea state to state, and now it's looking like it's going to be hard to implement.

CORNISH: That's NPR health correspondent Alison Kodjak. Alison, thank you.

KODJAK: Thank you for having me. Transcript provided by NPR, Copyright NPR.

Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.