Medicaid Work Rules Mooted by Pandemic Will Face High Court Scrutiny

Arkansas Gov. Asa Hutchinson speaks remotely to legislators in Little Rock, Ark., last month. Twelve Arkansas lawmakers have tested positive for the virus in November, the second largest known outbreak in a state legislature. (AP Photo/Andrew Demillo File)

WASHINGTON (CN) — The Supreme Court agreed Friday to hear argument about whether states can condition Medicaid enrollment on work requirements or job training. 

Arkansas adopted the scheme here with approval from the Trump administration in 2018, stating that people seeking Medicaid benefits between the ages of 19 and 49 had to either work or take part in educational or job-training programs for 80 hours a month to receive benefits.

States like Kentucky, Michigan and New Hampshire soon joined in with similar requirements. While some 18,000 lost coverage in Arkansas, court documents show that the number would have been 100,000 in Kentucky before that state abandoned its efforts. 

Neither Arkansas nor the U.S. Department of Health and Human Services has given up, however, even after the D.C. Circuit ruled in February that officials had excluded the statutory purpose of Medicaid.

“The court’s holding that HHS may not approve requirements that may serve as means to the ultimate end of providing coverage reflects a fundamental misreading of the statutory text and context,” Justice Department attorneys wrote in a petition for certiorari. “And its conclusion that work and skill-building requirements specifically are impermissible objects of experimentation in this context cannot be squared with history.” 

Opposing the Arkansas work requirements is lead plaintiff Charles Gresham, a 37-year-old man with schizophrenia represented by the law firm Jenner & Block and the National Health Law Program.

Noting that states have already agreed to not to restrict Medicaid eligibility as a condition to receive funding from the Families First Coronavirus Response Act, they say the controversy is moot.

HHS Secretary Alex Azar himself has conceded that no work requirement programs will go into effect until after Covid-19 infections have subsided in the country.

“Even absent the present constraints, it is hard to understand how the secretary could rationally implement work requirements that reduce coverage while the nation’s economy struggles amidst the worst pandemic in a century,” the brief on behalf of Gresham states. “The rate of unemployment stands at 7.7 percent and over 50 million Americans have filed for unemployment benefits since late March.”

Per their custom, the justices did not issue any comment Friday in taking up the case.

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