Monday, April 30, 2018

Bevin lawyers defend Medicaid changes, say beneficiaries who sued lack standing; brief makes a sort of Catch-22 argument

The Trump and Bevin administrations, defending the latter's forthcoming work requirements for Kentuckians on Medicaid, say the 16 beneficiaries who challenged them in federal court in Washington lack the legal standing to do so.

The governments asked District Judge James Boasberg to uphold the Centers for Medicare and Medicaid Servicesrecent approval of a waiver that lets the state charge premiums and co-payments and "require some beneficiaries to work 80 hours a month, go to school, enroll in job training or participate in similar activities," James Romoser reports for Inside Health Policy. "The new rules apply primarily to beneficiaries who received coverage through the Affordable Care Act’s expanded eligibility."

The government lawyers argue that the beneficiaries lack standing to sue because they have yet to lose any coverage. "For instance, the beneficiaries may receive exemptions from the work requirements or other coverage restrictions under the program scheduled to take effect July 1, the lawyers said. Kentucky added that, even if the beneficiaries were subject to the program’s restrictions, Boasberg cannot provide them with any favorable relief because, if the beneficiaries prevail, Gov. Matt Bevin has promised to eliminate the state’s Medicaid expansion," Romoser reports.

In an argument reminiscent of the conundrum described in the Joseph Heller novel Catch-22, the state's brief argues, “Plaintiffs have not established that prevailing here likely will redress their alleged injuries. To the contrary, if plaintiffs win, they no longer will receive Medicaid.”

Romoser reports, "The Trump administration said it is appropriate to test whether work requirements will serve that goal and promote overall health and well-being among the beneficiaries who will be subject to the program." Its brief says, “The requirement is not about penalizing Medicaid beneficiaries, as plaintiffs suggest. It is about promoting public health by encouraging members of the expansion population to engage in behaviors associated with healthy outcomes.”

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