- The U.S. Supreme Court said Friday it will hear arguments on whether Medicaid work requirements are legal. The demonstrations were a signature policy of President Donald Trump's administration, which approved some states to tie Medicaid expansion eligibility to job training or work.
- Lower courts have ruled against work requirements, noting they do not advance the objectives of Medicaid, which is to provide healthcare coverage to low-income people.
- The high court is unlikely to hear oral arguments in this case until after Inauguration Day on Jan. 20 as the court's calendar has already been set.
It's highly unlikely that the Biden administration will continue the Medicaid work requirement waivers. Although it's unclear how fast his administration could unwind the policy, according to experts. The decision to nix the waivers could render the case moot by the time it lands before the high court for oral arguments.
Under Trump, CMS Administrator Seema Verma encouraged states to test different incentives for eligibility of Medicaid coverage. State leaders interested in such waivers to reconfigure eligibility for those without disabilities were encouraged to apply for CMS approval.
But ultimately states were stymied in the courts as judges ruled against such policies.
In February, a federal appeals court struck down Arkansas' work requirement and called it "arbitrary and capricious" as it failed to advance the objective of the program. HHS approved Arkansas' waiver in 2018.
A critical issue in the case was the loss of coverage among Arkansas enrollees, nearly a quarter of those subjected to the requirement lost coverage.
This case was appealed to the Supreme Court, which has now decided to hear oral arguments and will consolidate similar cases, including one involving New Hampshire.
Eight states have approved work requirements, according to the Kaiser Family Foundation.
The program has raised eyebrows among policy experts and even government watchdogs. The Government Accountability Office raised concerns about the lack of oversight regarding administrative costs to implement work requirements. GAO said it costs taxpayers nearly $408 million in five states.
Former health officials under President Barack Obama criticized the program, noting it was costing millions to take away care from Americans. "More money, fewer people with care. And you paid for 87% of it!" Andy Slavitt, former CMS administrator, tweeted following the release of the report.
Another issue with work requirements is the inability of some to report their work or volunteer hours due to a lack of access to technology. KFF estimated that as many as 4.1 million could lose coverage as a result of work requirements.