First lawsuit filed against Kentucky’s Medicaid work rules. The health care of thousands is at risk.

Should governor lose in court, he'll boot 400,000 off health care

Dr. Derrick Hamilton listens to Breathitt County resident Mary Blair's heartbeat during her appointment at the Breathitt County Family Health Center on Tuesday, January 21, 2014 in Jackson, Ky. 

(CREDIT: Luke Sharrett/For The Washington Post via Getty Images)
Dr. Derrick Hamilton listens to Breathitt County resident Mary Blair's heartbeat during her appointment at the Breathitt County Family Health Center on Tuesday, January 21, 2014 in Jackson, Ky. (CREDIT: Luke Sharrett/For The Washington Post via Getty Images)

Kentucky Gov. Matt Bevin (R) upended the state’s Medicaid program two weeks ago by imposing work requirements, premiums, and other administrative changes on some enrollees. Changes to the half-century program will move 95,000 people off Medicaid coverage, state officials said. Advocates warned early on there would be lawsuits, and on Wednesday, the first one came.

The Southern Poverty Law Center, National Health Law Program, and Kentucky Equal Justice Center filed the class action lawsuit against the Department of Health and Human Services (HHS), arguing the Trump administration bypassed Congress to approve these changes, which do not promote the Medicaid Act’s objectives. The suit was filed in the U.S. District Court for the District of Columbia on behalf of 15 Medicaid beneficiaries in Kentucky.

Advertisement

Kentucky sought federal permission to alter its program through a Medicaid innovation waiver. The Trump administration approved Kentucky’s application just one day after rescinding Obama-era guidance on what the Medicaid program ought to do. The lawsuit argues that changes in policy cannot supersede the objections of the program outlined in the Social Security Act (1965), which includes the Medicaid Act and created the insurance program largely for low-income people.

Medicaid law requires states cover certain groups, and Kentucky wants to veer away from providing health care to these people by imposing things like work requirements and premiums. The Trump administration maintains Kentucky can do this through the waiver, but the complainants argue the changes do not promote the law’s objectives.

Kentucky’s new requirements aim to transition people off Medicaid, or Kentucky HEALTH, to save $2.4 billion dollars over the next five years.

The same day HHS approved the requirements, Bevin said he will end the state’s Medicaid expansion if a court blocks any part of these new changes.

Advertisement

“The Commonwealth will not be able to afford to continue to operate its Medicaid expansion program as currently designed in the event any one or more of the components of (the new program) are prevented by judicial action from being implemented,” Bevin wrote in an executive order.

The parties involved in the lawsuit filed Wednesday aren’t phased.

“The governor’s threat – to punish the 400,000 residents who have received Medicaid under the expansion if a court rules against the Kentucky HEALTH project – is shameless,” SPLC Deputy Legal Director Samuel Brooke said in a statement to ThinkProgress. “We will not be intimidated. We will defend the rights of individuals to enroll in Kentucky’s Medicaid program.”

Bevin’s executive order is complicated and may take years to execute, according to one health law expert.