After weeks of radio silence, the Trump administration finally announced their response to a federal court ruling striking down Kentucky’s Medicaid work requirements, which sent the rules back to the Department of Health and Human Services. Because the court said Trump’s HHS “entirely failed to consider” that tens of thousands of people will likely lose their health insurance under the new rules, the agency is reopening the public comment period for just 30 days and will in all likelihood reissue its approval.
It’s unclear whether the public comments will be any better this time around, as the intervening weeks have shown the restrictive Medicaid rules to be a disaster for Kentucky and the other states where they have been approved so far.
A new report from Fitch Ratings finds that Kentucky’s spending on administering Medicaid has jumped 40 percent due to the onerous work requirements, which require state employees to verify that all non-exempt adults on Medicaid are working at least 80 hours per month. Before it was put on hold by a federal court, the new Medicaid waiver cost the state $35 million more to enforce.
Additionally, Kentucky Gov. Matt Bevin (R) was forced to back down from his decision to slash dental and vision coverage for hundreds of thousands of adult Medicaid enrollees — a move he blamed on the federal judge’s ruling on his Medicaid waiver. There was widespread backlash to the cuts, which thanks to a glitch in the state’s records denied dental care to children and adults with disabilities in addition to the adults at which cuts were aimed. Bevin’s reversal casts further doubt on his threat to abolish the state’s Medicaid expansion if he doesn’t get it his way in court on work requirements.
Meanwhile, the damage Medicaid work requirements are wreaking in Arkansas is even worse than originally thought. The state, the first in the country to implement the work requirements, saw 7,464 residents fail to report their work hours. While Gov. Asa Hutchinson (R) writes off this drop to “they moved on in life, they might have moved, they might have got a better job,” providers on the ground say it’s much more likely that people are unaware of the rules or unable to navigate the new online-only bureaucracy.
The party that ostensibly loathes big government intrusion into local affairs is once again working to meddle in Washington D.C.’s self-governance. The GOP-controlled House of Representatives voted last week to block D.C. from enacting its own individual mandate penalty — a policy aimed at keeping insurance premiums from rising after Congress eliminated the national individual mandate penalty last year. D.C.’s fate is now in the hands of the Senate.
Finally, the very business groups that lobbied for years for the right to sell cheap, skimpy Association Health Plans that violate Obamacare’s rules now say such plans are unworkable after the Trump administration approved their proliferation. In an abrupt about-face, the National Federation of Independent Businesses says more legal changes are needed before such plans can realistically be offered.
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