Judge invalidates Michigan Medicaid work requirements

LANSING, Mich. (AP) — A federal judge on Wednesday invalidated work requirements for hundreds of thousands of Medicaid recipients in Michigan, one of two states where rules had been in effect after court challenges elsewhere.

The short order from U.S. District Judge James Boasberg in Washington, D.C., came weeks after a federal appeals court upheld his decision to strike down Arkansas’ requirement that low-income people work or do other things to qualify for government-provide health insurance.

The ruling was welcomed by Democratic Gov. Gretchen Whitmer, whose administration had sought a quick decision after unsuccessfully pushing to delay the rules that were enacted by her Republican predecessor and the GOP-controlled Legislature. Prior to the ruling, the state had been preparing to notify more than 80,000 of roughly 675,000 enrollees in Michigan’s Medicaid expansion program that they did not comply with reporting requirements for January and would lose their coverage on May 31 if they did not report for February and March.

“We just got a great victory in court,” Whitmer said, “so we’re going to be able to make sure that we’re continuing the effort to expand access to affordable health care.”

Four Michigan residents sued the federal government in November, with assistance from advocacy groups, contending that the Trump administration lacked the authority to approve the requirements that undermine the Affordable Care Act.

Starting Jan. 1, able-bodied adults ages 19 through 61 who wanted to maintain their benefits had to show workforce engagement averaging 80 hours a month under a 2018 law — through work, school, job training or vocational training, an internship, substance abuse treatment or community service.

While many participants in Healthy Michigan — the state’s Medicaid expansion program — were exempt from the rules, the state had said more than 100,000 were likely to lose coverage. It sent 238,000 letters in December notifying people they were subject to the requirements, though some were freed from having to report monthly if the state could verify their compliance in other ways. The rules do not apply to the more than 1.7 million state residents covered by the traditional Medicaid program.

Republican legislative leaders have defended the law. House Speaker Lee Chatfield tweeted that he was “very disappointed. Hard-working taxpayers are getting ripped off by having to foot the bill for able-bodied adults who choose not to work. Requiring welfare recipients to at least look for a job to get free government healthcare is common sense.”

Sen. Peter MacGregor, a Rockford Republican who chairs the Senate’s health and human services budget committee, said he expects the Trump administration to appeal to the Supreme Court.

“It’s not over. I think we need to be vigilant and prepare either way,” he told state Department of Health and Human Services Director Robert Gordon at a legislative hearing Wednesday.

Gordon, who like Whitmer opposes the workforce engagement requirements, said the state spent more than $30 million to comply with the law.

Sen. Marshall Bullock, a Detroit Democrat, said the rules were “a discriminatory, knee-jerk reaction to an ancient ideology about what Medicaid is. The fact is this: Medicaid is health care, and everyone deserves access to affordable health care.”

Though 10 states have had Medicaid work requirement waivers approved by the Trump administration, Utah is now the only one with rules in effect. Boasberg previously blocked the requirements in Kentucky, Arkansas and New Hampshire; and two other states, Arizona and Indiana, have blocked enforcement or implementation, citing litigation. Ohio, Wisconsin and South Carolina have not started their programs, according to the Kaiser Family Foundation.

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