Trump Administration Approves Legally Suspect Medicaid Waiver

WASHINGTON, Jan. 12 -- The National Health Law Program issued the following news release:

The Trump administration has approved Kentucky's request for exemptions from Medicaid law that could cost more than 95,000 low-income Kentuckians to lose health care coverage. The approval will allow the state to impose work requirements, charge premiums, prohibit re-enrollment of individuals who do not pay their premiums or meet other administrative requirements, eliminate retroactive eligibility, and eliminate coverage of non-emergency medical transportation.

The National Health Law Program's (NHeLP) Legal Director Jane Perkins said litigation is expected because the approval violates federal law.

"The U.S. Department of Health and Human Services' (HHS) approval is problematic for several reasons. For example, the federal law only authorizes the secretary to allow states to ignore Medicaid's consumer protections when a state is implementing an experimental project designed to promote the objectives of the Medicaid Act. While we are still reviewing the details of this approval, we have yet to identify such an experiment, and the action appears designed to achieve significant cuts in Medicaid enrollment rather than Medicaid's stated purpose of furnishing medical assistance to low-income people." Perkins said.

Perkins added, "Beyond its questionable legality, the approved waiver is going to hit low-income, working Kentuckians hard."

Focusing on some specifics of the approved waiver, NHeLP attorney Catherine McKee noted work requirements "are contrary to the purpose of the Medicaid program, will require costly and confusing ongoing reporting by Medicaid enrollees, and are also completely counterproductive - they block access to health services that individuals need to get and keep a job. Repeated research shows that the vast majority of Medicaid enrollees work or can't work for an understandable reason, such as a disabling condition."

McKee added, "The approved premiums have been well-studied through previous experimental projects - all concluded that premiums prevent low-income people from accessing medically necessary health care services." NHeLP's Health Policy Director Leonardo Cuello said that all of the approved Kentucky waivers will lead to negative health care outcomes.

"Adding obstacles to health care is wrong-headed policy and ignores an abundance of social science research concluding that the types of restrictions approved will limit enrollment in the Medicaid program, spurring uninsured rates and throwing vulnerable families into poverty or closer to poverty." Cuello said. "This is not what hard-working Kentuckians need. They need the state and federal governments working to ensure greater access to Medicaid so they can go on supporting their families and building communities."

See NHeLP's two sets of comments filed with HHS about Kentucky's waiver projects here and here. Please contact the NHeLP Communications department at [email protected] or 202-552-5176 to speak with Cuello, Perkins or McKee for additional comments and resources.

NHeLP, founded in 1969, advocates for the rights of low-income and underserved people to access quality health care.