Citing legal problems encountered by Kentucky and Arkansas, Arizona suspends its plan to add work requirements to Medicaid

Section 1115 waivers are the device being used to add work and other "community engagement" rules.

Arizona has indefinitely suspended its plan to add work requirements to its Medicaid program "due to legal uncertainty caused by several court rulings that have blocked other states from implementing the policy," including Kentucky, James Romoser reports for Inside Health Policy.

Arizona is one of 10 states where the Centers for Medicare and Medicaid Services allowed work requirements, and it is the first Republican-led state to reverse course, Romoser reports.

Kentucky, led by Republican Gov. Matt Bevin, was the first state to be approved, but a federal judge in Washington, D.C., blocked its plan twice, and stopped a similar plan that had already taken effect in Arkansas. A three-judge appellate panel appeared skeptical of both plans in a hearing Oct. 11.

The panel is expected to rule within a few months. Bevin is seeking re-election Nov. 5 against Democratic Attorney General Andy Beshear, who has pledged to drop the plan if elected because "This is paperwork and it is intended to tear health care away from people," as he said in an Oct. 15 debate with Bevin.

Bevin told Beshear, "This isn't about people being, having anything ripped away from them. What I propose is that people work and or volunteer and or go to school or be in training or take care of someone in exchange" for their benefits.

Bevin's original proposal estimated that in five years, Kentucky's Medicaid rolls would have 95,000 fewer people than they would without the plan, largely because of noncompliance. Academic health experts said in a friend-of-the-court brief that a more likely range was 175,000 to 297,500. Medicaid covers 1.4 million Kentuckians, around 450,000 of them under the expansion.

Studies have indicated that most people who would be affected by the work rules are already meeting them. One study based on polling found that 97% were already meeting the requirements; another, based on claims data, showed that 64% were.