�Թϲ�����

A federal judge on Monday blocked Medicaid work requirements in New Hampshire, ruling for a third time that the Trump administration hasn't adequately addressed the potential loss of health coverage for low-income residents. The ruling by U.S. District Judge James E. Boasberg in Washington comes four months after he blocked similar work requirements in Arkansas and Kentucky. (7/29)

The ruling marks the third state for which U.S. District Judge James E. Boasberg has held that federal health officials were “arbitrary and capricious” when they approved the state plans, failing to consider the requirements’ effects on low-income residents who rely on Medicaid for health coverage. Boasberg, of the U.S. District Court for the District of Columbia, blocked New Hampshire’s plan four months after he ruled that Arkansas needed to stop the work requirements it had begun the previous June. At the same time, the judge struck down similar requirements in Kentucky for a second time. (Goldstein, 7/29)

Just as in Kentucky and Arkansas, Boasberg ruled that the Department of Health and Human Services (HHS) failed to take into account how many people subject to the work requirements would lose Medicaid coverage. HHS did not offer its own estimates of coverage loss, nor did it address the many comments projecting that the proposal would lead to a substantial number of residents being taken off the Medicaid rolls, Boasberg ruled. (Weixel, 7/29)

Medicaid beneficiaries who were subject to the state's work requirements were supposed to start reporting their work or volunteer hours in June. New Hampshire was set to start cutting those who didn't comply by August. But earlier this month, state health department Commissioner Jeffrey Meyers told GOP Gov. Christopher Sununu and the legislature in a letter that he would delay the community engagement provisions until the end of September. He cited pragmatic considerations, including the need for IT system updates and testing. (Luthi, 7/29)

Arkansas reported terminating coverage for over 17,000 individuals in 2018 before the work requirements program was shut down in 2019. The Department of Health and Human Services is expected to appeal the ruling, but has not yet released a formal statement. HHS is seeking an appeal of Boasberg’s decisions in both Kentucky and Arkansas. (Raman, 7/29)

Dawn McKinney with New Hampshire Legal Assistance, which served as co-counsel to plaintiffs in the case, reacted to the ruling on Monday afternoon. “This is huge. It’s going to give our clients and thousands of Granite Staters peace of mind,” said McKinney. “I think a lot of people will sleep better tonight knowing that their health insurance isn’t at risk.” (Moon, 7/29)

Gov. Chris Sununu issued a statement Monday calling the decision “disappointing but not surprising given this judge’s past rulings.” “New Hampshire’s work requirement is a key provision of the bi-partisan Medicaid expansion bill that passed with overwhelming support in the legislature,” Sununu said in a statement. “New Hampshire clearly demonstrated that the state was implementing its work requirement responsibly and in a manner that would ensure that no individual would inappropriately lose coverage. A ruling from one federal trial court judge in Washington, D.C. is only the first step in the process, and we are confident that New Hampshire’s work requirement will ultimately be upheld.” (Feely, 7/29)

The Trump administration's rejection of Utah's plan to partially expand Medicaid could send other states back to the drawing board on covering more low-income people under President Barack Obama's signature health care law. The decision is disappointing for leaders in conservative-leaning states who considered Utah's plan a compromise approach, said Matt Salo, executive director of the National Association of Medicaid Directors, on Monday. (7/29)

The Trump administration's rejection Friday of Utah's request for full Affordable Care Act funding for a partial Medicaid expansion likely ends the hopes of leaders in a number of states for a smaller and cheaper coverage program for low-income adults. Idaho and Georgia are two other states that currently are considering partial expansions. There are an estimated 2.5 million uninsured adults in non-expansion states who could qualify for Medicaid nationally through partial expansions, according to the Kaiser Family Foundation. (Meyer, 7/29)

Medicaid expansion advocates are eyeing 2020 wins in red states by taking the issue straight to voters, a strategy that yielded success last year in other Republican-led states. Proponents are petitioning Florida, Missouri and Oklahoma to include ballot measures asking residents if they want to broaden out the federal health care program to cover more low-income adults, many of whom are uninsured. (Hellmann, 7/30)

Ignoring the advice of community physicians and their own medical staff, officials overseeing Minnesota's Medicaid program have limited payments for birth control under certain conditions — one of several decisions that critics describe as missteps that are restricting patient access to critical forms of care. The agency has also been faulted for delaying access to a drug regarded as the gold-standard treatment for opioid addiction and limiting access to cutting-edge drugs for hepatitis C, a disease that is spreading rapidly. (Howatt, 7/29)

A government watchdog agency shined the spotlight on the funding disparities within Medicaid's disproportionate-share hospital program, finding four states' DSH payments exceeded their hospital uncompensated-care costs. The Government Accountability Office report released on Monday illustrated the unevenness of federal DSH spending as California, Illinois, Maryland and Missouri exceeded uncompensated-care costs, but Tennessee's DSH payments represented 0.7% of its Medicaid funding. Maine's payments represented nearly 97% of Medicaid funding. (Luthi, 7/29)

The longtime medical director of Minnesota’s Medicaid program is opening up about problems within the sprawling Department of Human Services, one month after he lost his job. In an open letter to Gov. Tim Walz and state lawmakers Monday, Dr. Jeff Schiff called leaders of the agency’s health care administration “hostile and dismissive” and said they often ignored clinical evidence when making key health care decisions. He called on state leaders to establish a mechanism for ongoing oversight of the agency, which has a nearly $18 billion budget and oversees a range of programs for vulnerable residents. (Faircloth, 7/29)