The state of Kentucky requested a waiver from the Centers for Medicare and Medicaid Services (CMS) to impose work requirements on Medicaid beneficiaries. CMS approved the state’s request. On June 29, the Federal District Court for the District of Columbia invalidated the waiver approval, however. See Federal Judge Blocks Kentucky’s Medicaid Work Requirements (Vox, 6/29/18). The court did not declare that work requirements can never be established as a condition of Medicaid eligibility. Rather, the court’s ruling was based on the fact that the administration failed to consider a “salient factor” in deciding to grant a waiver – the waiver’s impact on furnishing medical assistance. The Secretary’s failure to consider this factor rendered his decision “arbitrary and capricious” (a common legal basis for invalidating federal regulations). See Medicaid Work Requirements: Inside The Decision Overturning Kentucky HEALTH’s Approval (Health Affairs blog, 7/2/18). The ruling directly affects only Kentucky’s waiver, and the decision can be appealed by the administration. CMS Administrator Seema Verma said that the agency will be conferring with the Department of Justice to consider next steps.
On July 2, Kentucky Governor Matt Bevin (R) announced that he would be canceling dental and vision benefits for the “able-bodied” adults who became eligible for Medicaid under the expansion allowed by the Affordable Care Act (the “expansion” population), unless they earn the benefits. See Bevin Cuts Dental, Vision Benefits To Nearly 500K Medicaid Recipients (Louisville Courier Journal, 7/2/18). This is the population on which he sought to institute work requirements.