D.C. Circuit rules against HHS approval of Arkansas Medicaid work requirements

The United States Court of Appeals for the District of Columbia Circuit ruled against an attempt to allow Arkansas to institute work requirements for Medicaid recipients.

On February 14, 2020, a three-judge panel of the D.C. Circuit ruled in Gresham v. Azar that Secretary of the U.S. Department of Health and Human Services (HHS), Alex Azar, failed the arbitrary-or-capricious test when he approved a request from Arkansas to require its Medicaid beneficiaries to work at least 80 hours per month.

The court held that Azar was wrong not to consider whether the Arkansas work requirements would prevent some people from receiving health care coverage. The court held that Congress intended Medicaid to provide health care coverage and that HHS must uphold that purpose when approving state coverage plans.

The Trump administration announced in January 2018 that it would allow states to implement work requirements for Medicaid recipients by obtaining waivers from HHS. Arkansas, Kentucky, and New Hampshire received waivers, but Judge James Boasberg of the United States District Court for the District of Columbia blocked them from going into effect. The D.C. Circuit decision in _Gresham_ followed an appeal of Boasberg’s ruling filed by Arkansas.

The judges on the D.C. Circuit panel were Cornelia Pillard, an Obama appointee, Edwards, a Carter appointee, and David Sentelle, a Reagan appointee. Judge Sentelle filed the opinion for the court.

To learn more about the APA or the arbitrary-or-capricious test, see here:
Administrative Procedure Act
Arbitrary-or-capricious test

Additional reading:
Alex Azar 
Medicaid
Motor Vehicle Manufacturers Association of the United States, Inc. v. State Farm Mutual Automobile Insurance Company 
James Boasberg
United States District Court for the District of Columbia 

Link to the D.C. Circuit opinion: https://ij.org/wp-content/uploads/2020/02/19-5094.pdf




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