The Trump administration on Tuesday asked a federal appeals court to revive Medicaid work requirements in Kentucky and Arkansas.
HHS and the Justice Department told the U.S. Court of Appeals for the District of Columbia Circuit that the agency properly reviewed the Section 1115 proposals and that the work requirements are policy experiments that support Medicaid's mission, arguments the federal district judge rejected in both cases.
"The goal of the policies is to encourage compliance, and the terms and conditions of approval include safeguards intended to minimize coverage loss due to noncompliance," the agencies wrote. "There is, of course, no requirement that HHS quantify the outcome of the experiments in advance."
U.S. District Judge James Boasberg struck down Arkansas' and Kentucky's work requirements. In his March ruling, he said that financial independence and health aren't objectives of Medicaid in their own right, noting that HHS didn't give an estimate on how many people could lose coverage.
But HHS told the appeals court that work requirements were carefully created to target able-bodied adults in the Medicaid program, and it considered the risk that some beneficiaries might lose coverage due to noncompliance.
"There is no doubt that freeing state resources in this manner furthers the objectives of Medicaid," HHS and the Justice Department said in their brief. "The Supreme Court has long recognized that requirements that enable states to stretch limited resources promote the objectives of public welfare programs."
Arkansas' work requirement program installed last year has led to more than 18,000 people going off the program for non-compliance or lack of reporting.
So far the CMS has also approved waivers for Indiana, Arizona, Ohio, New Hampshire, Utah, Michigan and Wisconsin.
The work requirement program requires able-bodied Medicaid expansion beneficiaries to complete 20 hours a week of either work, education, volunteering or job training to maintain coverage.
The administration argued in its brief that the requirements were modeled after other conditions of eligibility for assistance programs such as the Supplementary Nutrition Assistance Program.