Trump administration appeals rulings that blocked Medicaid work rules in Ky. and Ark.; decision not likely until after Nov. 5 election

U.S. District Judge James Boasberg

As expected, the Trump administration has appealed a decisions by a federal judge in Washington, D.C., that stopped Kentucky and Arkansas from requiring some people on Medicaid to work.

The Centers for Medicare and Medicaid Services appealed April 10 to U.S. Court of Appeals for the District of Columbia, “which often has the final say on the legality of controversial regulatory policies,” reports James Romoser of Inside Health Policy. Gov. Matt Bevin has said the issue will be decided by the U.S. Supreme Court, which could refuse to hear a further appeal.

The Trump administration is “expected to argue that Boasberg, an Obama appointee, failed to provide enough leeway to HHS Secretary Alex Azar to test new policies that he believes will serve Medicaid’s goals,” Romoser writes. “Encouraging states to pursue work requirements has been a key policy priority for Azar and CMS Administrator Seema Verma.”District Judge James Boasberg “ruled that CMS failed to show how the waivers would promote Medicaid’s central purpose of providing people with medical coverage,” Romoser notes. “Boasberg’s rulings sent the waivers back to CMS for further review, meaning CMS had the option to re-evaluate or modify the waivers in hopes of satisfying Boasberg’s concerns. But the agency indicated in court papers last week that, rather than take any further action on the waivers right now, it intended to bring the case to the D.C. Circuit and seek to have Boasberg’s rulings overturned.”

Appeals in federal courts are randomly assigned to three-judge panels. “It is not clear whether a single panel will oversee both the Arkansas and Kentucky cases,” Romoser writes. “Among the D.C. Circuit’s 11 full-time judges, seven were appointed by Democratic presidents and four were appointed by Republican presidents. The court also has six senior judges, who handle a reduced caseload. Five of them are Republican appointees and one is a Democratic appointee.”

The cases are likely to spend several months at the D.C. Circuit, probably beyond the Nov. 5 election, in which Bevin is highly likely to be the Republican nominee for another four-year term. Kentucky officials have intervened in the case and have said they will participate in the appeal. The Kentucky case is Stewart v. Azar, No. 1:18-cv-152.

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