Campaign Action
Kentucky Gov. Matt Bevin, of course a Republican, has been having a prolonged hissy fit with Medicaid expansion in his state, a resounding success under his Democratic predecessor. When the Trump administration said states could impose work requirements on Medicaid enrollees, Bevin was the first governor to jump on it. When people sued, Bevin said every court decision against him would be answered with benefits being taken away.
He followed through on that threat a few weeks ago, with the first federal court ruling that said the Trump administration had overreached and couldn't make poor people jump through humiliating hoops to keep their coverage. He took away vision and dental benefits. The backlash from providers losing patients was immediate, and now Bevin has relented, restoring the benefits of dental and vision care to 400,000 Kentuckians while it reworks the plan.
Reaction from health advocates was relief mixed with "we told you so." Health advocate Sheila Schuster simply said, "Hooray." Jason Bailey, with the Kentucky Center for Economic Policy, said that the "two weeks that they eliminated dental and vision coverage is a glimpse of what will happen" if Bevins ultimately succeeds in his pursuit of work requirements. He's trying again, of course, working with the Trump administration to reapply.
The Trump administration is doing its worst to make that happen fast. It's opening another 30-day comment period possibly with an eye to stacking the comments—which were previously strongly against the proposal—in their favor. In blocking the Medicaid overhaul, Judge James Boasberg was clear that HHS Secretary Alex Azar had ignored public comment about the impact of the requirements.
"The record shows that 95,000 people would lose Medicaid coverage, and yet the [HHS] Secretary paid no attention to that deprivation. Nor did he address how Kentucky HEALTH would otherwise help 'furnish ... medical assistance,'" […] Boasberg wrote. […] "In other words, he glossed over 'the impact of the state's project' on the individuals whom Medicaid 'was enacted to protect.'"
The administration and the state seem to think that opening up the comment period again, giving them the chance to load the comments with more favorable assessments will answer the judge's concerns. It's not clear what substantive changes, if any, the administration is considering to the work requirements rule.