Judge blocks New Hampshire Medicaid work requirements

CONCORD, N.H. (AP) — A federal judge on Monday blocked Medicaid work requirements in New Hampshire, ruling for a third time that the Trump administration hasn't adequately addressed the potential loss of health coverage for low-income residents.

The ruling by U.S. District Judge James E. Boasberg in Washington comes four months after he blocked similar work requirements in Arkansas and Kentucky.

The judge said "we have all seen this movie before" and criticized U.S. Secretary of Health and Human Services Alex Azar for acknowledging the potential impact without analyzing it.

"What does the Secretary think about all this? Does he concur with New Hampshire's apparent view that coverage loss is going to be minimal, or does he agree with the commenters that is likely to be substantial?" he wrote in vacating the agency's approval of the rules. "Are the coverage losses in Arkansas likely to be replicated in New Hampshire? We have no idea, since the approval letter offers no hints."

While supporters argue that work requirements help participants achieve self-sufficiency, the judge ruled that they undermine the Medicaid program's mission of providing health care for the needy. In Arkansas, more than 18,000 people lost coverage last year, but were eligible to re-enroll in January. Boasberg said New Hampshire's program likely presents even greater coverage-loss concerns because it requires more monthly hours of work and applies to a wider age range of participants.

Critics say those requirements would jeopardize health care for hardworking people struggling with child care, transportation and other issues while working low-wage jobs with fluctuating hours. The New Hampshire lawsuit was brought on behalf of a 26-year-old sporting goods cashier, a 40-year-old man who does seasonal work and lives off the land and a married couple with three young children.

"We are really pleased with the decision and happy for our clients and thousands of Granite Staters who are going to sleep better tonight knowing they don't have to worry about their health coverage," said Dawn McKinney of New Hampshire Legal Assistance, which filed the lawsuit along with the National Health Law Program and the National Center for Law and Economic Justice.

Earlier this month, New Hampshire officials said they were delaying implementation of the requirements until the end of September after finding that fewer than a third of the 25,000 people subject to the rules were in compliance in June, the first month for which participants had to document their hours.

Though New Hampshire's reauthorization of its expanded Medicaid program was a bipartisan effort, the work requirements have become a source of division. While Democrats praised the ruling, Republican Gov. Chris Sununu expressed disappointment. He defended the requirements, saying the state was ensuring that no one would "inappropriately lose coverage."

"A ruling from one federal trial court judge in Washington, D.C. is only the first step in the process, and we are confident that New Hampshire's work requirement will ultimately be upheld," he said in a statement.

The Trump administration is appealing the earlier rulings involving Kentucky and Arkansas. A spokesman for the Centers for Medicare and Medicaid Services declined to comment Monday.