A federal court struck a major blow on Friday against the Trump administration’s crusade for Medicaid work requirements — a pillar of the government’s health care agenda. D.C. District Court Judge James Boasberg’s scathing ruling raked the Trump administration over the coals for approving Kentucky’s Medicaid waiver without considering the massive coverage losses the new rules would trigger in the state — 95,000 fewer people insured by the state’s own estimate.
Already, Kentucky Gov. Matt Bevin (R) is making good on his threat to punish Medicaid recipients in his state if he lost in court. Over the weekend, the state notified about 460,000 adults enrolled in the Medicaid expansion that their dental and vision care would be cut off. People who were enrolled in Medicaid before the state expanded will not be impacted. Bevin has additionally threatened to end the state’s Medicaid expansion entirely, but only after all appeals are exhausted in the battle over the work requirements waiver.
And though the Trump administration has already hinted that it will appeal Friday’s ruling, the sweeping court victory for the challengers has boosted similar legal efforts already in the works in other states where the administration has approved work requirements, including Indiana and Arkansas.
Meanwhile, the face-off over Maine’s Medicaid expansion drags on, with Gov. Paul LePage (R) issuing yet another veto of a bill to expand Medicaid — his sixth since taking office! Lawmakers could try to override the veto when they reconvene on July 9. The state’s Medicaid expansion that voters overwhelmingly approved last November to cover an additional 70,000 low-income people was scheduled to go into effect on Monday, but LePage is fighting it on multiple fronts. Now, he is appealing a state court ruling that said he must move forward with the implementation, and the Maine Supreme Judicial Court will hear that appeal on July 18. The health care advocates suing LePage are telling eligible Mainers to go ahead and apply for Medicaid now, because if they eventually prevail in court, those people will receive retro-active benefits.
More and more signs are emerging that Obamacare’s individual market is surprisingly resilient in the face of a year-plus onslaught of damaging policy changes from the Trump administration. More insurers are entering the market, enrollment has largely held steady and has even increased among some demographics.
But more threats to the markets are on the horizon. The individual mandate officially dies in 2019, and insurers are already citing its demise as the key factor in their decision to make double-digit rate hikes, which are likely to price many people out of the market entirely. Additionally, the Trump administration is planning to slash funding even further for navigator groups who have helped millions of people enroll in the individual market over the past few years. In 2017, the administration cut navigator funding nearly in half, even as a shortened enrollment period and other changes made their work more vital than ever. Now, officials are considering cutting the groups’ remaining budget by nearly two-thirds, to just $10 million nationwide.
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