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April 18, 2022 01:10 PM

Supreme Court tosses Medicaid work requirement cases

Maya Goldman
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    The Supreme Court on Monday tossed out cases challenging Medicaid work requirements in Arkansas and New Hampshire.

    The justices said lower courts should vacate their prior rulings nixing the work requirements, as the cases are moot. But work requirements are still being debated in the lower courts, since Georgia sued the Centers for Medicare and Medicaid Services over the agency's decision to pull approval for the state's planned requirements.

    The Supreme Court agreed in late 2020 to hear the Arkansas and New Hampshire cases after a federal appeals court struck down the policies. But it canceled oral arguments in March 2021 while the Biden administration reviewed proposed Medicaid work requirements in several states.

    CMS revoked permission for Arkansas' and New Hampshire's work requirements later that month. CMS has now pulled approval for requirements in the12 states that originally earned approval, saying the policies don't promote Medicaid's objectives.

    CMS rescinded Georgia's approval for work requirements in December. The state's lawsuit, filed in January, called the decision a "regulatory bait and switch of unprecedented magnitude." A motion hearing in the case is set for June 20.

    The Trump administration encouraged states to impose Medicaid work and community engagement requirements starting in 2018, under the assumption that such standards would incentivize work. But prior to the COVID-19 pandemic, more than six in 10 adults on Medicaid already worked, with nearly half working full-time, according to the Kaiser Family Foundation.

    Arkansas was the only state to begin disenrolling people from Medicaid for not meeting work requirements. The state upheld work requirements for 10 months, until a federal judge shut down the program in 2019. During that time, about 18,000 people lost coverage. The policy did not boost employment, a 2020 Health Affairs study found.

    Medicaid work requirements could have weakened hospitals' finances if implemented, according to a report from the Commonwealth Fund.

    The Supreme Court's order can be found here.

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