Trump administration asks Supreme Court to reinstate Arkansas Medicaid work requirements

The Trump administration on Tuesday asked the Supreme Court to reinstate Medicaid work requirements in Arkansas.

The Department of Justice in a filing said a federal appeals court was wrong to block the Department of Health and Human Services from approving work requirements in Arkansas, and the decision “reflects a fundamental misreading of the statutory text and context.”

According to the administration, work requirement demonstrations help a state stretch its “limited resources” by keeping borderline populations out of Medicaid. 

The administration argued the requirements will allow beneficiaries to transition to other forms of coverage, and will free up state funding from people who might not need it.

In addition, DOJ argued the decision of the appeals court can’t be allowed to influence the 17 other work requirement demonstrations that have either already been approved or are awaiting approval.

“If the court of appeals’ decision … is allowed to stand, it very likely will be binding in litigation over any of those other projects,” DOJ argued. “This Court should review the D.C. Circuit’s holding before it becomes entrenched as a de facto nationwide rule.”

The administration said an intervention by the Supreme Court would allow states to implement Medicaid work requirements “once public-health conditions related to COVID-19 allow.”

Medicaid work requirements have been atop the administration’s health care agenda. Under ObamaCare, states were given the option to expand Medicaid to childless low-income adults who didn’t previously qualify for the program.

The Trump administration has argued that “able-bodied” adults should work instead, and that Medicaid should be reserved for children, people who are pregnant, adults who are disabled and very-low income residents.

The administration’s view is that work requirements help lift people out of poverty by getting them jobs, and out of Medicaid into employer-based insurance.

Opponents of work requirements say the rules don’t do anything to improve public health and are instead designed to kick people out of the Medicaid program.

Earlier this year, the U.S. Court of Appeals for the D.C. Circuit affirmed a lower court ruling that the approval of the work requirements was “arbitrary and capricious.”

More than 18,000 people lost their Medicaid coverage in Arkansas in the five months the requirements were in effect before they were blocked by the court.

Arkansas Attorney General Leslie Rutledge also filed a request for the Supreme Court to review the case.

“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 in a statement. 

Rutledge said the program supports 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.”

Work requirements have faced a string of legal losses, as courts ruled that Congress would need to act to authorize the work requirements. 

Arkansas was the only state where the requirements went into effect before being blocked. Several other states’ efforts were approved by the administration, but the initiatives have been halted as the issue works its way through the courts.