© Silas Walker/APRepublican Gov. Matt Bevin had threatened to discontinue Medicaid expansion in the state, which covers more than 500,000 people, if the requirements were struck down.
The requirements would have gone into effect Sunday. Republican Gov. Matt Bevin had threatened to discontinue Medicaid expansion in the state, which covers more than 500,000 people, if the requirements were struck down.
U.S. District Judge James Boasberg, an appointee of former President Barack Obama, stated in his ruling that the Trump administration's decision to add work requirements was "arbitrary and capricious" because it did not consider whether it would help bring medical care to citizens, which is one of the goals of the program under Obamacare. He noted that studies showed 95,000 people would be rolled off of Medicaid in Kentucky if the plan were to go into effect.
Instead, the Trump administration had put more weight on whether the program would promote health among residents. A central argument from the administration has been that work promotes better health, which is one of the objectives of the Medicaid program.
But Boasberg countered that the Medicaid program was transformed under Obamacare from a program designed for certain needy groups of people to one that is intended to cover people below a certain income level.
"Defendants in this case have sought to roll back those reforms," he wrote, adding later that it was "no secret" that the administration wanted to roll back Obamacare entirely.
Though an administration has authority to change parts of Medicaid, he wrote, "that discretion is not boundless."
Fifteen Medicaid beneficiaries in Kentucky sued the Trump administration in January in the U.S. District Court for the District of Columbia over the work requirements. The National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center are representing the plaintiffs.
In the complaint, the groups said federal officials violated Medicaid law by adding the work requirement provision, which they argue can be changed only through Congress. Medicaid waivers, they wrote, are intended to expand access to coverage or improve health.
They argued that states are not allowed to impose additional requirements on the program. Under Obamacare, states were allowed to expand coverage to people of under specific income level, regardless of work status. Medicaid otherwise covers pregnant women, people with disabilities, people in nursing homes and children, who do not need to abide by the work requirements. Caregivers and people undergoing treatment for addiction also are exempt.
The complaint also said the Administrative Procedure Act was violated, which requires presidents "take care that the laws be faithfully executed."
The plaintiffs said they could be harmed under the changes because they would have to abide by reporting requirements and face difficult barriers such as inadequate transportation or lack of access to a computer.
Defenders of work requirements say Medicaid could help people find employment so that they no longer need to be covered by the program, which is offered to people making roughly $16,000 a year or less.
CMS Administrator Seema Verma called the decision "disappointing."
"States are the laboratories of democracy and numerous administrations have looked to them to develop and test reforms that have advanced the objectives of the Medicaid program," Verma said in a statement. "The Trump Administration is no different. We are conferring with the Department of Justice to chart a path forward."
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