The ideological battle over the Affordable Care Act’s Medicaid expansion continued to run hot in 2019, with state Republican officials pushing to impose restrictions on coverage even in states where voters mandated it.
GOP elected officials in Idaho, Nebraska and Utah delayed full implementation of voter-approved Medicaid expansion and sought to impose work requirements and other restrictions on eligibility.
But a federal judge threw out the Medicaid work requirement waivers in three other states, saying the CMS didn’t adequately consider the effect on coverage. A decision by a federal appellate court is pending. The lesson of Arkansas, where 18,000 people lost coverage in 2018 under a work requirement rule, loomed large in the legal and political arguments.