Where Medicaid Work Requirements Go, Lawsuits Follow

A number of states have tied Medicaid coverage to work requirements. But legal challenges have followed — a sucessful attempt to stop the program in Kentucky, an ongoing lawsuit in Arkansas and possibly more to come.

The first substantive arguments were filed last week in a lawsuit against Arkansas' Medicaid waiver program. The state has removed thousands of people from its Medicaid program since June, when it began requiring some participants to work 80 hours a month.

Leonardo Cuello is with the National Health Law Program, one of the groups challenging that policy. Federal law allows states to experiment with their Medicaid programs to improve health care, but Cuello said changes like work requirements create more problems.

“They don’t actually furnish care for anyone, they actually do the exact opposite," Cuello said. "They take care away from people.”

A federal judge agreed when he put Kentucky’s Medicaid waiver program on hold in June just days before it was scheduled to go into effect, the result of a lawsuit that Cuello's organization was involved in. Kentucky's program is still under review. 

Indiana, Wisconsin and New Hampshire have also been given government approval to implement work requirements. Cuello said his organization is watching closely. 

“We are, as always when seeing things that are legally troubling, considering the possibility of taking legal action,” Cuello said. “It’s impossible to predict whether a lawsuit will be filed by us or by anybody else, but given the legally problematic things they are doing and the great potential harm to people in the state, it seems very possible that litigation could happen.”

Indiana plans to gradually roll out its work requirement next year for some enrolled in the Healthy Indiana Plan (HIP), the state's expanded Medicaid program.

A government spokesman said Indiana is confident its program is structured to avoid a legal challenge.

"We recognize that communication is key and will continue to focus on member education throughout the phase in of the program starting in 2019," spokesman Jim Gavin wrote in an email. "We are also actively seeking partners across the state to help connect HIP members to opportunities to work, further their education or serve their communities."

This story was produced by Side Effects Public Media, a news collaborative covering public health.