But despite the Supreme Court’s willingness to take up the issue, the incoming Biden administration might have other ideas, and opponents called on it to reverse endorsement of the work requirements.
A unanimous and ideologically diverse panel of the U.S. Court of Appeals for the D.C. Circuit ruled in February that President Trump’s health officials had been “arbitrary and capricious” in allowing Arkansas to launch a Medicaid program called “Arkansas Works” two years ago.
The goal of Trump’s Department of Health and Human Services was to allow states to experiment with job-training or work requirements on some of those whose access to Medicaid health benefits was facilitated by the Affordable Care Act.
Acting Solicitor General Jeffrey B. Wall, asking the Supreme Court to accept the case, said the law allows the HHS secretary to approve programs that might enhance reaching the objectives of the Medicaid program.
In this case, to “test whether certain requirements promote those objectives by requiring certain working-age, nondisabled adults to engage in work or skill-building activities (such as job-skills training or general education) as a condition of continued eligibility for Medicaid benefits,” Wall wrote.
“The secretary determined that such requirements may help beneficiaries transition to employer sponsored or federally subsidized commercial coverage and may lead to improved beneficiary health, which in turn may help states conserve resources that can be redirected to providing other coverage.”
But judges who have addressed the issue said the purpose of Medicaid was to provide the needy with health benefits, not to shed those eligible for its help.
“Failure to consider whether the project will result in coverage loss is arbitrary and capricious,” the appeals court opinion by Judge David B. Sentelle said.
The ruling noted that during the five months that Arkansas Works was in effect before being blocked by a judge, more than 18,000 Medicaid recipients were dropped from the program.
The work-requirement programs have been challenged by recipients in the states and other organizations. They told the Supreme Court there was no need to review the lower court decisions.
“During a pandemic in which 50 million Americans have filed for unemployment and nearly 12 million have lost employer-sponsored health insurance, the secretary of Health and Human Services asks this court to revive demonstration projects that would allow states to kick people off Medicaid for failing to seek and obtain jobs that are not there,” wrote Washington lawyer Ian Heath Gershengorn.
As a practical matter during the health crisis, he said, Congress has conditioned increased Medicaid funding on an agreement not to reduce Medicaid eligibility. So the programs could not go forward until the crisis is over, he said.
Jane Perkins, legal director of the National Health Law Program, said she was confident the justices “will ultimately conclude that these agency actions were not legal.”
But the cases won’t be considered until sometime in the spring, and the department will have new leadership before then.
“The Biden administration can certainly change this policy, and we hope that will happen,” Perkins said in a statement.
The combined cases are Azar v. Gresham and Arkansas v. Gresham.
Amy Goldstein contributed to this report.