The administration approved a package of changes to New Hampshire’s Medicaid program, including the new work requirements, in November. It aims to overhaul Medicaid state by state, after a wholesale revamp of the program sank in 2017 with Republicans’ failed attempt to repeal the Affordable Care Act.
A spokesman for the Centers for Medicare and Medicaid Services declined to comment on the lawsuit. The official said the administration remains committed “to considering proposals that would give states more flexibility to engage with their working-age, able-bodied citizens.”
The New Hampshire suit comes after oral arguments were held last week at a federal court in Washington related to two other lawsuits challenging Medicaid work requirements in Arkansas and Kentucky.
The stakes are high: Kentucky Gov. Matt Bevin, a Republican, has said he would end the state’s Medicaid expansion if a court blocks the work-related requirements set to begin April 1. Other Republican governors have sought work requirements in exchange for agreeing to expand Medicaid coverage at all.
So far, 36 states and Washington, D.C., have expanded Medicaid under the Affordable Care Act.
Critics say the administration’s approval of the work requirements amounts to a circumvention of Congress’s will and an attack on the poor.
“This approval will not promote coverage, but it will result in significant coverage losses, and that is the administration’s goal,” said Jane Perkins, legal director of the National Health Law Program, which filed the suit on behalf of the New Hampshire residents.
Under the Affordable Care Act, Medicaid has grown to cover about 75 million people, or one in five Americans, up from 50 million when the law was enacted in 2010, according to federal data. The increase is due in part to broader income-based eligibility. This has helped lower the nation’s uninsured rate, but critics of the law say expanded eligibility has burdened state budgets and has given benefits to people who could instead get jobs with health coverage.
Arkansas initiated the state’s first-ever Medicaid work requirement in June, and more than 18,000 people lost coverage through December. Arkansas state officials say there were a variety of reasons for the disenrollments, including recipients who had died or didn’t return requested information.
The Trump administration faces criticism over comments Health and Human Services Secretary Alex Azar made in a hearing last week, suggesting that most of the 18,000 people dropped from Medicaid rolls hadn’t re-applied to the program because they had found jobs. The administration was unable to point to data that substantiated Mr. Azar’s claim.
Seven GOP-led states have received approval from the Trump administration for work-related requirements, according to the San Francisco-based Kaiser Family Foundation, a nonprofit. Eight other requests are pending, and a number of other states are considering the requirements. States have also received approval to require copays, as well as to restrict benefits and eligibility.