Medicaid Update:

Kentucky’s intention to implement its Work Requirement Program on April 1 this year was halted this week by a ruling by U.S. District Judge James Boasberg. Kentucky Governor Matt Bevin is now threatening to reverse the state’s adoption of Medicaid expansion under the parameters set forth by the Affordable Care Act if they are not allowed to proceed with the Work Requirement waiver – a step that would deprive 400,000 newly enrolled recipients of their Medicaid coverage.

Kentucky can re-submit their Work Requirement waiver applications to CMS (after revision), but it is not clear as to whether they will at this point. Judge Boasberg’s decision “vacates” their current waivers at the federal level because they permit misuse of the authority given to the Executive Branch by Congress (in this case) to provide medical coverage.

Another consequence of this decision is that other states will likely proceed very cautiously (if at all) with regard to implementing such waivers. As shown in last week’s column, six other states have received approval from CMS to implement Work Requirements, but haven’t yet done so. States will inevitably ask themselves if it is worthwhile to spend significant money on setting up such programs only to have them halted by judicial decisions.  New Hampshire’s program, launched March 1, is the only currently active program.