HHS to Defend Onerous Work Requirement Projects in Arkansas and Kentucky on March 14 in Federal Court

HHS to Defend Onerous Work Requirement Projects in Arkansas and Kentucky on March 14 in Federal Court

HHS Secretary Tells House Committee He Does Not Know Why People Are Losing Medicaid in Arkansas

Washington D.C – The Trump administration’s HHS secretary and Kentucky Medicaid officials do not know why Arkansans are losing Medicaid under the Arkansas work requirement. But attorneys for HHS, Arkansas and Kentucky Medicaid officials will defend the legality of both Medicaid waiver plans, which include work requirements, and additional obstacles to Medicaid along with cuts to services before U.S. District Court  Judge James Boasberg on March 14. Following is information on both cases, followed by information on how to hear from counsel after oral arguments.

In fall 2018, Kentucky Cabinet for Health and Family Services Secretary Adam Meir testified before Kentucky lawmakers, “We don’t know what happened to the folks in Arkansas yet,” and suggested that overtime low-income individuals would find jobs with access to comprehensive health care in the state. [The state is hardly creating enough jobs that provide access to even basic health care; reporters might review Bureau of Labor Statistics or speak with the Economic Policy Institute regarding job growth in Kentucky and Arkansas.]


On March 12, HHS Secretary Alex Azar testified before a House committee and told Rep. Joe Kennedy that he had no information on why people in Arkansas are losing access to Medicaid coverage. Azar also could not cite any evidence so-called work requirements make people healthier. If such study exists, Azar said he would send it to Kennedy.


What will the lawyers for these officials tell a federal court judge in D.C. on March 14 in two cases challenging the legality of the Arkansas and Kentucky Medicaid waiver plans that include work requirements and other obstacles to Medicaid, which Trump’s HHS approved.

The Trump administration’s U.S. Department of Health and Human Services will defend its approval of conditioning Arkansas and Kentucky Medicaid coverage on individuals meeting onerous work requirements. The Arkansas work requirements, in effect, have already yanked thousands of Arkansans from access to necessary health care.

Oral arguments on summary judgement motions and the government’s motion to dismiss the Arkansas case, Gresham v. Azar, are set for March 14, 10 a.m. EDT before Judge James E. Boasberg of the U.S. District Court of the District of Columbia. Oral arguments in the Kentucky case, Stewart v. Azar, will follow at 11 a.m., also before Judge Boasberg. HHS argues these cases are intertwined.

Arkansas Waiver Case, 10 a.m.

The National Health Law Program, Legal Aid of Arkansas, and Southern Poverty Law Center are representing a group of Arkansans who are harmed by the amendment to Arkansas’s waiver project for Medicaid expansion. The National Health Law Program is advised in the case by the law firm, Jenner & Block. Ian Gershengorn, partner at Jenner & Block and National Health Law Program board member, will argue the case before Judge Boasberg. In addition to allowing Arkansas to condition Medicaid coverage on work, the government’s approval also permits the state to limit individuals to reporting information by computer and eliminate three-month’ retroactive coverage. When Arkansans fail to meet the work requirements for three months, they are out of Medicaid for the remainder of the year. More than 18,000 people have been terminated from Medicaid coverage in the first five months.

National Health Law Program Legal Director Jane Perkins said, “In its early days, the Trump administration announced its intent to explode the Affordable Care Act’s Medicaid expansion, and HHS has responded, in part, by approving the amendment to Arkansas’s Medicaid waiver project. The stated purpose of the Medicaid Act is to furnish medical assistance to individuals in need; work requirements ignore this essential role. We are hopeful that the court will vacate the federal approval of the Arkansas amendment as it did the approval of a similar Kentucky project last June.”

Legal Aid of Arkansas Attorney Kevin De Liban said, “The approved amendment undermines – instead of bolsters – access to Medicaid services. Medicaid helps people stay healthy enough to work. Therefore, it does not make any sense to make people jump through needless and costly hoops when they are often already working or trying to take care of family members. Ultimately, these extra hurdles harm our clients’ health and ability to keep working and caring for their families.”

Southern Poverty Law Center Deputy Legal Director Sam Brooke said, “The U.S. Department of Health and Human Services and CMS have violated the U.S. Constitution and federal laws by approving Arkansas’ work requirements. It is our hope that the court will recognize the harm to thousands of low-income people in the state who have been or will be kicked off the Medicaid program as result of these illegal requirements and, in due course, put a halt to the Trump administration’s reckless effort to transform Medicaid from a health insurance program to a work program.”

Kentucky Waiver Case, 11 a.m.

The National Health Law Program, Kentucky Equal Justice Center, and Southern Poverty Law Center are representing a group of Kentuckians, who will lose Medicaid if Kentucky’s Medicaid waiver project is upheld by the courts.

National Health Law Program Legal Director Jane Perkins said, “Early on, the Trump Administration announced its intent to explode the Affordable Care Act’s Medicaid expansion, and HHS has responded, in part, by approving the Kentucky HEALTH project. This approval has been vacated once before by Judge Boasberg, and the re-approval suffers from the same legal problems. The HHS secretary received more than 11,000 additional comments after the court decision, the vast majority of them warning that re-approval would lead to extensive loss of coverage because of the project’s burdensome restrictions. Indeed, a similar work mandate in Arkansas has jettisoned thousands of low-income adults from coverage in just the first four months.”

Kentucky Equal Justice Center Litigation and Advocacy Counsel Ben Carter said, “The facts and evidence have not changed. The program’s harmful work mandate will not result in people getting insurance and working. Instead, the changes will yank health coverage from Kentuckians who need medical care to find and keep jobs. Kentucky’s Governor and HHS failed to listen to the Court when they resubmitted and re-approved essentially the same project the Court previously struck down, a project that will lead to needless loss of health care coverage for hundreds of thousands of Kentuckians.”

Southern Poverty Law Center Deputy Legal Director Samuel Brooke said, “The Trump administration’s latest approval of Kentucky HEALTH is just another attempt to convert Medicaid – which is supposed to provide health coverage and care to those who need it most – into a work program. This is wrong legally. But more important, it is wrong morally—tens of thousands of low-income individuals will lose access to coverage if these changes are allowed to go into effect.”

Counsel for plaintiffs in both cases will be available for comment after conclusion of the Kentucky oral arguments, outside of the courthouse on 3rd Street entrance (William B. Bryant Annex entrance).

Please contact Jeremy Leaming, National Health Law Program, [email protected], or Andy DiAntonio, [email protected]; Ben Carter, KEJC, [email protected]; Kevin De Liban, [email protected]; or  Josh Dorner with SPLC at [email protected].

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