The federal Court of Appeals for the District of Columbia heard appeals today of lower court rulings striking down work requirements for expanded Medicaid coverage in Arkansas and Kentucky.

No word yet on how the questioning went. The appeals court didn’t rule today. It will take weeks or months.


The lower court found that the work rule, which threw thousands off coverage, ran counter to the core objective of Medicaid, to provide medical care. Arkansas’s process was particularly faulty, beginning with, initially, computer-only reporting requirements for a poor population without access or knowledge of computers.  Furthermore, the GAO has reported, it cost $26 million to implement and increased the cost of health coverage.

The National Health Law Program, Southern Poverty Law Center, and Jenner & Block are representing affected Medicaid enrollees. Kentucky Equal Justice Center and Legal Aid of Arkansas are co-counsel in their
respective cases.


UPDATE: The Washington Post reports questions from the appeals court panel expressed skepticism about the work rules. All three judges said the states had failed to consider people who’d lose medical insurance.

Noting that state Medicaid experiments must fulfill the basic purposes of the program, Judge Harry T. Edwards told a Justice Department attorney, “You are failing to address the critical statutory objective” of providing vulnerable residents with health coverage.


The attorney, Alisa Klein, of Justice’s civil division, said the administration believes that requiring low-income people to work, or prepare for jobs, can improve their health and ultimately help them get private health plans, freeing up money that states could use for additional Medicaid benefits.

“The other things you say may be laudable goals, but to say they outweigh the principal goal [of Medicaid] seems a bit strange,” said Judge David B. Sentelle, nominated by President Ronald Reagan and the only Republican appointee on the panel.

The judges dismissed the argument that a similar requirement existed in the food stamp program. The programs aren’t comparable, they said.