Health Care

Federal Appeals Court Strikes Down Trump’s Medicaid Work Requirements in Arkansas


A federal appeals court on Friday rejected the Trump administration’s approval of Medicaid work requirements in Arkansas, saying the administration had neglected to consider the coverage loss people would suffer as a result.

A three-judge panel on the U.S. Court of Appeals for the D.C. Circuit unanimously upheld a lower court ruling striking down the work requirements, ruling that Department of Health & Human Services does not have authority to require some people covered by Medicaid to work, attend job training, volunteer, or attend school.

“Failure to consider whether the project will result in coverage loss is arbitrary and capricious,” the court stated in its opinion, written by Judge David Sentelle, a Reagan appointee.

“We agree with the district court that the alternative objectives of better health outcomes and beneficiary independence are not consistent with Medicaid,” the court said. “The text of the statute includes one primary purpose, which is providing health care coverage without any restriction geared to healthy outcomes, financial independence or transition to commercial coverage.”

More than 18,000 Arkansas residents lost their health-care coverage when the work requirements went into effect before a lower court struck them down. The state was the only one where work requirements went into effect, albeit briefly. Work requirements have also been struck down by federal judges in New Hampshire and Kentucky.

More than 10 million additional low-income people gained Medicaid coverage after they became eligible under the Affordable Care Act. Medicaid currently covers approximately 70 million people across the country.

Republican Arkansas Governor Asa Hutchinson said he hopes the case will reach the Supreme Court, saying the work requirements were intended to help recipients get job opportunities while they received benefits.

“It is difficult to understand how this purpose is inconsistent with federal law,” Hutchinson said. “The court’s ruling undermines broad public support for expanded health care coverage for those struggling financially.”

The National Health Law Program, representing those who lost coverage when the work requirements went into effect, commended Friday’s ruling.

“It means that thousands of low-income people in Arkansas will maintain their health insurance coverage — coverage that enables them to live, work, and participate as fully as they can in their communities,” said legal director Jane Perkins.

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