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CMS Invites Additional Comments on Contested Medicaid Work Requirements

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After a federal judge invalidated the previously approved plan by the Centers for Medicare & Medicaid (CMS) to require very low income parents and caregivers to show that they are working or engaged in other activities in order to qualify for Medicaid coverage in Kentucky, CMS re-released the rule and another one governing Mississippi for additional comments.

As we discussed earlier this month, the judge in the Kentucky case blocked the work requirement because the court found that the agency was “arbitrary and capricious” in its decision-making, and showed no evidence that it considered the concerns that stakeholders raised in comments on the proposal. The decision found that the agency did not appear to independently evaluate the waiver’s impact on coverage for people with Medicaid, which it is required to do in approving any waiver. The judge returned the issue to CMS, requiring them to adequately consider these factors. This return, called a remand, is not normally directly appealable, so to challenge the court’s ruling, CMS will have to release its own new decision and then defend that decision in a future case.

In addition to CMS’s re-release of the Kentucky waiver for additional comments, the agency also re-released for public comment a Mississippi proposal that has been adjusted following the court decision in the Kentucky case. The Mississippi proposal also contemplates work requirements, but extends health coverage for two years for people who become over-income and ineligible for Medicaid by meeting the work requirement.

Read more about the Kentucky lawsuit.

Read a summary of responses or submit a comment on the waiver.

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