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'All Too Familiar': Judge Blocks N.H. Medicaid Work Requirements

Analysis  |  By Steven Porter  
   July 29, 2019

The same federal judge has tossed out the Trump administration's approval of Medicaid work requirements in three states.

U.S. District Judge James Boasberg, who previously blocked Medicaid work requirements in Kentucky and Arkansas, halted a similar set of requirements Monday in New Hampshire.

Boasberg issued a decision vacating the federal government's approval of the work requirements in New Hampshire for reasons that track closely with his decisions in the two prior states.

"The issues presented in this case are all too familiar," he wrote, outlining his view that Health and Human Services had again failed to consider fully the possibility that many people could lose health insurance as a result of the policy.

Boasberg's decision came after New Hampshire officials delayed their rollout of the new work requirements amid loss-of-coverage concerns. Two-thirds of the beneficiaries to whom the state's work requirements would apply—that's nearly 16,900 people—had failed to demonstrate compliance by the deadline, so state officials have launched a ramped-up campaign to raise public awareness.

Although the HHS secretary has wide discretion to approve demonstration projects that he or she expects to further the Medicaid program's statutory objectives, the judiciary have an important role to ensure that government agencies make reasoned decisions after considering the relevant factors, he wrote, finding that HHS had again fallen short.

Supporters of these work requirements have said the policies help beneficiaries climb out of poverty by giving them stronger incentives to work. Opponents have expressed concerns, however, that the added hurdles will simply result in more poor people being barred from Medicaid coverage over technicalities.

Boasberg's order granted summary judgment for the plaintiffs, vacated the requirements and remanded them to HHS for further proceedings, and scheduled a follow-up hearing for August 28. His decisioin will almost certainly prompt an appeal, as federal officials are continuing to defend their actions on the Kentucky and Arkansas programs before the U.S. Circuit Court of Appeals for the District of Columbia.

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.

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