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Supreme Court to Hear Case on Trump’s Work Requirements for Medicaid

WASHINGTON – The Supreme Court on Friday agreed to decide whether the Trump administration can impose work requirements on Medicaid recipients, a question that could become moot if the Biden administration removes the requirements.

In February, a panel of three unanimous judges from a federal appeals court in Washington struck down the requirements, which would have denied Medicaid health care coverage to poor people in Arkansas and New Hampshire unless whether they are working, volunteering or training for a job.

The appeals court said the approval of the requirement by Health and Human Services Secretary Alex M. Azar II was illegal – “arbitrary and capricious,” in legal jargon – because it had not considered how this would advance Medicaid’s goal of providing health care to the poor.

Congress had sought to “provide health care coverage to populations who otherwise could not afford it,” Judge David B. Sentelle wrote for the court. “Importantly, the secretary did not take this statutory objective into account in his analysis.

The case of Azar v. Gresham, No. 20-37, will be heard early next year.

Urging the Supreme Court to hear the case, Jeffrey B. Wall, the acting solicitor general, said the government should be allowed to test new approaches to the Medicaid program, especially in light of its expansion under the Affordable Care Act.

The appeals court ruling, he wrote, “threatens to hamper innovations that can make state Medicaid programs more effective and sustainable” and “casts a shadow over approved or pending demonstration projects. of several other States ”.

Mr Wall wrote that requirements similar to those blocked by the appeals court had been approved or were pending in 17 other states.

Lawyers for the challengers told judges the administration’s timing was particularly bad.

“During a pandemic in which 50 million Americans filed for unemployment and nearly 12 million lost employer-sponsored health insurance,” they wrote, “the secretary of health and social services is asking this tribunal to revive demonstration projects that would allow states to kick people out of Medicaid for not looking for and getting jobs that don’t exist. “

The rules require “able-bodied” adults to report to their state each month that they have worked, researched or trained for a job, attended school, or volunteered in order to maintain Medicaid coverage. Administration officials said that work is linked with good health and it helps people avoid poverty and government dependency.

The appeals court questioned this reasoning, saying it was not supported by the objectives of the law.

“The text of the law includes a primary objective, which is to provide health care coverage without any restrictions focused on healthy outcomes, financial independence or the transition to commercial coverage,” Justice Sentelle wrote.

In Arkansas, more than 18,000 people lost their coverage before the work was blocked. Some people with jobs lost their coverage because they didn’t know the rule or didn’t report their hours to the state.

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