Supreme Court Agrees to Consider Medicaid Work Requirements

Supreme Court Agrees to Consider Medicaid Work Requirements
The Supreme Court in Washington on March 10, 2020. (Samira Bouaou/The Epoch Times)
Matthew Vadum

The Supreme Court has agreed to a request by the Trump administration to review an appeals court ruling that struck down pilot programs in Arkansas and New Hampshire that required Medicaid recipients to work.

The court took action Dec. 4 granting petitions for review requested in two related cases, Azar v. Gresham and Arkansas v. Gresham, and consolidated them. One hour in total was allotted for oral argument, but the hearing has not yet been scheduled. The court gave no explanation for its action, as is its custom.

“I am grateful the U.S. Supreme Court will weigh the merits of this case,” Arkansas Gov. Asa Hutchinson, a Republican, said in a statement.

“The ability of a state to conduct Medicaid demonstration projects like Arkansas Works is of national significance. It has always been our goal to provide healthcare to an expanded population of Arkansans while also providing tools for them to achieve economic stability and independence.”

Arkansas Attorney Gen. Leslie Rutledge, also a Republican, said in a statement that she was pleased the court will hear the case. “Arkansas Works reaffirms Arkansas’s commitment to ensure the Medicaid program is sustainable.”

The office of New Hampshire Gov. Chris Sununu, a Republican, didn't immediately respond to requests for comment from The Epoch Times.

Medicaid is a joint federal-state program that serves low-income people of all ages and varies from state to state. It's run by state and local governments within federal guidelines. Each state sets its own rules about eligibility and services. Although patients usually don’t have to pay for covered medical expenses, a small co-payment is sometimes required.

Medicaid work requirements have been a priority of the Trump administration’s health care agenda. Under Obamacare, states had the choice of whether to expand Medicaid to childless low-income adults who failed to qualify for the program previously. The Trump administration says “able-bodied” adults should have to work, and that Medicaid ought to serve children, pregnant women, disabled adults, and residents with very low incomes.

The Trump administration had granted waivers to the two states, allowing them to condition government-funded health coverage on employment. But a panel of three federal judges invalidated the pilot programs, finding that by requiring recipients to work, volunteer, or receive job training, the states undermined the goal of Medicaid, which is to give low-income individuals access to health care.

Congress tried “to provide health care coverage to populations that otherwise could not afford it,” Judge David Sentelle of the U.S. Court of Appeals for the District of Columbia previously wrote for the court.

“Importantly,” Sentelle wrote, U.S. Health and Human Services Secretary Alex Azar “disregarded this statutory purpose in his analysis.”

The fate of the Obamacare statute itself is currently before the Supreme Court, as The Epoch Times reported last month. The Trump administration urged the court Nov. 10 to uphold the Dec. 14, 2018, ruling of Judge Reed O’Connor of the Northern District of Texas who held that the Patient Protection and Affordable Care Act became unconstitutional in its entirety when Congress reduced the individual mandate penalty to zero. O’Connor stayed the ruling during the appeals process.

The Trump administration previously argued in a filing with the Supreme Court that work requirements assist a state in stretching its finite Medicaid resources.

Acting U.S. Solicitor General Jeffrey B. Wall said in the petition that the Social Security Act “authorizes the Secretary of Health and Human Services to approve ‘any experimental, pilot, or demonstration project’ proposed by a State that, ‘in the judgment of the Secretary, is likely to assist in promoting the objectives’ of the Medicaid program.”

“Exercising that authority, the Secretary approved demonstration projects in Arkansas and New Hampshire designed to test whether certain requirements promote those objectives by requiring certain working-age, non-disabled adults to engage in work or skill-building activities (such as job-skills training or general education) as a condition of continued eligibility for Medicaid benefits.”

The HHS secretary found that the requirements “may help beneficiaries transition to employer-sponsored or federally subsidized commercial coverage and may lead to improved beneficiary health, which, in turn, may help States conserve resources that can be redirected to providing other coverage.”

Critic Jane Perkins, legal director of the National Health Law Program, a left-leaning advocacy organization, said in a statement that she was optimistic the high court will side with the appeals court.

"While we firmly believe that these Petitions did not merit review, we are confident that the Supreme Court will ultimately conclude that these agency actions were not legal," she said.

If the high court fails to do so, “tens of thousands of people would lose their Medicaid coverage and become uninsured.”