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New Hampshire residents sue Trump administration over work requirements for Medicaid recipients

This is the third legal challenge against the administration's most consequential health policy.  

US President Donald Trump delivers remarks  with Health and Human Services Secretary Alex Azar (R) on reducing drug costs in the Rose Garden at the White House in Washington, DC, on May 11, 2018. (Photo by NICHOLAS KAMM / AFP)        (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
US President Donald Trump delivers remarks with Health and Human Services Secretary Alex Azar (R) on reducing drug costs in the Rose Garden at the White House in Washington, DC, on May 11, 2018. (Photo by NICHOLAS KAMM / AFP) (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)

Low-income residents in New Hampshire are suing the Trump administration for approving the state’s Medicaid work requirement, a group of health advocacy organizations announced Wednesday.

This is the third legal challenge against the administration’s most consequential health policy. The administration has already allowed eight states to condition Medicaid eligibility on reported work.

The administration first approved New Hampshire’s work requirement in November 2018, mandating certain Medicaid recipients report at least 100 hours of work or volunteer opportunities per month. The administration approved the rule as part of a waiver that also cut services like retroactive coverage.

The state has already implemented the waiver, with retroactive coverage ending in January 2019. Those with Medicaid insurance will need to report work hours in June 2019, and their coverage could be terminated for noncompliance starting in August 2019.

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The National Health Law Program (NHeLP)New Hampshire Legal Assistance, and National Center for Law and Economic Justice filed a lawsuit on Wednesday against the administration in D.C. district court on behalf of four Medicaid recipients. Notably, the groups are not suing the state of New Hampshire.

One of the plaintiffs is 40-year-old Ian Ludders, who supports himself with seasonal work in orchards and farms and won’t be able to meet the 100-hour-per-month requirement. “These subsistence activities are also important to him because they enable him maintain his own self-sufficiency by living off the land,” the lawsuit reads.

The lawsuit asserts that the federal court should find the New Hampshire waiver unlawful for violating the Administrative Procedure Act (APA), a federal law that governs how agencies need to operate; the Social Security Act; and the U.S. Constitution. Federal judges have ruled against the Trump administration at least 63 times and two-thirds of the cases have accused federal officials of violating the APA, according to The Washington Post.

“Congress has defined the scope of the secretary’s power to waive portions of the Medicaid Act, and those waivers must further Medicaid’s stated objective of furnishing medical assistance,” Jane Perkins, NHeLP legal director, said in a statement. “We filed this case because the federal government ignored these limits in its effort to fundamentally transform Medicaid and ‘explode’ the Affordable Care Act’s expansion of health coverage for medically necessary services that low-income adults need.”

“This approval will not promote coverage, but it will result in significant coverage losses, and that is the administration’s goal — to weaken the Medicaid program and cull people whom it deems unworthy from it,” she added.

A federal judge already ruled against the administration’s work requirements once before. District Judge James “Jeb” Boasberg, an Obama appointee, called the administration “arbitrary and capricious” in June 2018 for giving Kentucky the okay when it didn’t adequately consider the consequences. Unfazed, Kentucky resubmitted a nearly identical Medicaid work requirement.

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Advocacy groups, including NHeLP, filed a lawsuit against Kentucky’s new work rules as well as Arkansas, whose work requirement policy resulted in over 18,000 residents losing coverage.

Boasberg, who is overseeing both lawsuits, said he will issue a decision by the end of the month.