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December 18, 2019

Kentucky officially withdraws its Medicaid work requirement waiver

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    Kentucky's new governor, Andy Beshear (D), on Monday rescinded the state's waiver to impose work requirements and premiums on many of the state's Medicaid beneficiaries.

    Your cheat sheets for understanding health care's legal landscape

    Kentucky's Medicaid work requirements, as well as Medicaid work requirements in several other states, have faced legal challenges. A federal judge earlier this year blocked Medicaid work requirements in Arkansas, Kentucky, and New Hampshire. A three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit in October heard oral arguments in the Arkansas and Kentucky cases, and experts say the judges appeared likely to support the lower court's ruling against the requirements. Some states have chosen to pause their efforts to implement Medicaid work requirements in light of the legal challenges.

    Beshear rescinds Medicaid work requirements waiver

    Under Kentucky's former governor, Matt Bevin (R), the state received federal permission to implement work and premium requirements for certain Medicaid beneficiaries, but the requirements—as well as those in several other states—have been blocked by a federal court, so they have not yet taken effect. Bevin had vowed to continue pursuing the requirements if he was re-elected.

    In contrast, Beshear—who was serving as the state's attorney general and is the son of former Kentucky Gov. Steve Beshear (D), who expanded the Kentucky's Medicaid program under the Affordable Care Act—during his campaign against Bevin said his "goal is to make sure every single Kentuckian has some form of [health] coverage, and that we lower the cost for every single Kentucky family."

    Upon his election, Beshear said he planned during his first week in office to rescind the Medicaid waiver that granted Kentucky permission to implement the work requirements. Beshear took office on Dec. 10.

    According to the Wall Street Journal, Beshear on Monday sent a letter notifying CMS that the state will no longer implement the work requirements.

    "Rescinding this waiver is not only the right thing to do, it is the moral, faith-driven thing to do," Beshear said Monday. He added, "This Medicaid waiver would have cost Kentucky money, lives, and jobs."

    According to a release from Beshear's office, the governor's actions "effectively en[d] Kentucky's litigation involving the waiver in federal court … and [Beshear] has asked the court to dismiss Kentucky from the lawsuit."

    Beshear on Monday also signed an executive order intended to protect Kentucky's Medicaid expansion, the Journal reports. Bevin last year signed an executive order that directed state officials to terminate the expansion if a court permanently blocked the state from implementing Medicaid work requirements, but Beshear's new executive order rescinds the one signed by Bevin.

    Advocate praises moves

    Emily Beauregard, executive director of Kentucky Voices for Health, called Beshear's moves "a huge victory for consumer health advocates and the thousands of Kentuckians who raised their voices to oppose harmful barriers to care." She continued, "More than 400,000 Kentuckians can breathe easier … knowing that they won't be at risk of losing access to the health care services they need to maintain their health, can go to work without worrying about an illness or injury, and can take care of their families" (Campo-Flores, Wall Street Journal, 12/16; Weixel, The Hill, 12/16; Acquisto, Lexington Herald-Leader, 12/16; Staley, Beshear release, 12/16).

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