A publication of the Kentucky Center for Public Service Journalism

Kentucky HEALTH delayed by federal judge, halts plan to require Medicaid recipients to work

Staff report

A federal judge ruled Friday the Department of Health and Human Services (HHS) failed to adequately consider how Kentucky’s proposed Medicaid work rules would affect residents’ access to health care as required under federal law.

The ruling halts implementation of the state’s proposal which would have required Medicaid recipients to work, volunteer or otherwise engage in community activity in order to receive benefits.

Kentucky’s Sec. 1115 waiver plan called “Kentucky HEALTH,” was set to take effect on July 1. The judge’s decision remands the Kentucky waiver plan back to the U.S. Department of Health and Human Services (HHS) to reconsider it in accordance with Sec. 1115 of the Medicaid Act.

Sixteen low-income Kentuckians challenged federal approval of Governor Bevin’s Medicaid waiver plan. In the opinion issued Friday, federal district Judge James Boasberg favored the plaintiffs, vacating the Health and Human Services (HHS) Secretary’s approval of Kentucky’s 1115 Waiver known as Kentucky HEALTH.

Judge Boasberg is a U.S. District Judge on the District Court for the District of Columbia.

The judge’s ruling blocks implementation of the waiver in its current form.

Because of the ruling, Kentuckians will continue to be able to access health care services through Medicaid.

Thirteen states have applied to the federal government to implement similar work requirements. Kentucky was the first state to receive approval for its request.

Kentucky Cabinet for Health and Family Services (CHFS) Secretary Adam Meier said, “The Court’s ruling invalidates Kentucky HEALTH on a very narrow basis. The Court concluded that the HHS Secretary simply failed to consider the impact of Kentucky HEALTH on Medicaid coverage.

“While we disagree with the Court’s ruling, which delays implementation of Kentucky HEALTH, we look forward to working with CMS to quickly resolve the single issue raised by the Court so that we can move forward with Kentucky HEALTH. Without prompt implementation of Kentucky HEALTH, we will have no choice but to make significant benefit reductions.

Click to read ruling

“Kentucky HEALTH is an innovative, thoughtfully crafted program that will strengthen Medicaid by engaging beneficiaries in their own health outcomes.  Able-bodied Kentuckians deserve to have a stake in their health and will benefit from the dignity that comes from career training, education, and volunteer opportunities that are available as part of Kentucky HEALTH’s community engagement program.  We will fight to preserve these opportunities for our citizens so that we can proceed with the only viable path forward for expanded Medicaid in Kentucky.”

A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:

“Medicaid is an essential source of health coverage for 2.3 million Americans with a history of cancer and millions more who are at risk for the disease. The program enables patients to get timely cancer screenings, appropriate cancer treatment, and long-term follow-up care. As cancer treatment can sometimes be debilitating, patients often find themselves unable to work or are advised not to by their physicians. Meeting reporting requirements or maintaining work to keep their Medicaid coverage could be overly challenging for cancer patients and survivors due to ongoing symptom management and could result in worse health outcomes.

“Preserving access to Medicaid without additional obstacles, like work requirements, is essential to ensuring cancer patients and those with other serious diseases can get the care they need.

“We will continue to work with states across the country to expand access to quality health care.”

Read the 60-page ruling here.

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