U.S. Supreme Court

Supreme Court will decide legality of work requirements for Medicaid recipients

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The U.S. Supreme Court on Friday agreed to decide whether the U.S. Department of Health and Human Services lawfully authorized Arkansas and New Hampshire to test work requirements for Medicaid recipients.

The court agreed to consider the question in two consolidated cases, report SCOTUSblog, the Washington Post and the New York Times. The SCOTUSblog case pages are here and here, and the cert petitions are here and here.

The U.S. Court of Appeals for the District of Columbia Circuit had ruled in February that the decision to authorize the Arkansas work program was arbitrary and capricious. The appeals court rejected the Medicaid requirements in New Hampshire in an unpublished per curiam opinion in May.

It’s possible that the Supreme Court case would become moot if the Biden administration rejects the requirements, the articles report. But SCOTUSblog points out that repealing the work requirements could take time, and states could challenge repeal in an administrative hearing.

The Arkansas program requires some Medicaid recipients to spend at least 80 hours per month on activities that include working, looking for work, job-skills training, education and community service, according to this cert petition.

The Arkansas work requirement applies only to who received benefits as a result of the Medicaid expansion in the Affordable Care Act. The program contains exceptions for those who are frail, pregnant, caring for a child under age 6, participating in a substance abuse program, or in school full time.

The work requirement in New Hampshire also applies to those covered by ACA’s Medicaid expansion, the cert petition said. Those beneficiaries would have to spend at least 100 hours per month in activities similar to those of the Arkansas project.

According to the D.C. Circuit opinion in the Arkansas case, more than 18,000 Medicaid recipients in the state lost coverage within five months as a result of the work requirement. The number is about a quarter of the people who were subject to the work requirement.

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