Dive Brief:
- A class-action lawsuit filed in federal district court in Washington, D.C., challenges work requirements for Medicaid enrollees Michigan plans to put into place Jan. 1. The plaintiffs include four current Medicaid enrollees, and the suit was filed by attorneys with the National Health Law Program, the Michigan Poverty Law Program and the Center for Civil Justice. The defendants are HHS Secretary Alex Azar and CMS Administrator Seema Verma.
- The work rules would impact about 270,000 of the current 670,000 enrollees in Healthy Michigan, the state's Medicaid program.
- The lawsuit is one of many that have challenged Medicaid work requirements in the nine states that have obtained such waivers. Most of the litigation has prevailed to date.
Dive Insight:
Michigan originally expanded Medicaid eligibility under the Affordable Care Act in 2014, even with a Republican, Rick Snyder, as governor. However, the Trump administration has undertaken various initiatives to undermine the ACA, including inviting states to apply for 1115 waivers to introduce work requirement rules for their Medicaid enrollees.
Most critics of the rule say it merely buries Medicaid enrollees under burdensome reporting rules that would inevitably lead to their being disenrolled.
Current Gov. Gretchen Whitmer has noted that between 61,000 and 183,000 Medicaid enrollees would lose their coverage as part of the requirements to either have a job, look for work or be enrolled in a job training or rehabilitation for substance abuse. Whitmer, a Democrat, was elected after the GOP-controlled Legislature and former governor passed legislation to seek a waiver from CMS.
The Michigan suit was filed by attorneys with the National Health Law Program, the Michigan Poverty Law Program and the Center for Civil Justice. It claims that the work requirements are not a demonstration project intended to further the intent of Medicaid Act, the law that created the program in the mid-1960s. It also claims the Trump administration's invitation to submit work-related waivers circumvents the will of Congress and violates the Constitution. It is seeking class-action status as well as a permanent injunction against putting the work rules into effect, along with legal fees.
Lawsuits have been able to at least stall work requirement waivers obtained in eight other states. For example, Indiana delayed implementing its work requirement earlier this month after it was sued over the matter. Last spring, a federal judge struck down work requirements in Kentucky and Arkansas. Those cases are currently being appealed by the U.S. Justice Department.
Meanwhile, other states have been undeterred by the litigation. Idaho announced in late September that it would seek a work requirement waiver from the Trump administration.
Also, the ACA itself remains in legal limbo, with a ruling expected any day know from an appeals court in a lawsuit challenging the legislation's constitutionality.