Amy Howe

Dec 4 2020

Justices agree to review legality of Medicaid work requirements

The Supreme Court announced on Friday afternoon that it would weigh in on the legality of the Trump administration’s approval of Medicaid work requirements in Arkansas and New Hampshire. In a brief order, the justices granted review in Azar v. Gresham and Arkansas v. Gresham and consolidated the cases for one hour of oral argument.

The U.S. Court of Appeals for the District of Columbia Circuit ruled in February that the approval should be thrown out. The court ruled that, in green-lighting the work-requirement programs, Secretary of Health and Human Services Alex Azar failed to consider whether they would result in Medicaid beneficiaries losing health coverage. By tying Medicaid coverage to employment, job training or community service, the programs risked undermining the goal of furnishing health coverage – which, the court of appeals reasoned, is a “principal objective of Medicaid.”

Both Azar and Arkansas went to the Supreme Court, telling the justices that the D.C. Circuit’s decision is wrong and, if allowed to stand, could threaten efforts by other states to implement programs that promote the “health or financial independence, or both,” of Medicaid recipients.

Assailing the federal government for asking the Supreme Court – during a pandemic – for permission “to revive demonstration projects that would allow States to kick people off Medicaid for failing to seek and obtain jobs that are not there,” the challengers urged the justices to deny review. Not only is the D.C. Circuit’s ruling correct, they stressed, but the government now seeks to defend its decision to approve the work requirements on a ground that it never cited in that decision.

The cases likely will not be argued until late winter or early spring. Law professor Stephen Vladeck suggested on Friday that the administration of President-elect Joe Biden could rescind the government’s approval of the work requirements after taking office, potentially resulting in the case becoming moot before the argument. Rescinding the approval, however, likely would take time, and the state would be entitled to an administrative hearing to challenge an attempt to rescind it.

The court is expected to issue more orders from Friday’s conference on Monday morning at 9:30 a.m. EST.

This post is also published on SCOTUSblog.

Amy L Howe
Until September 2016, Amy served as the editor and reporter for SCOTUSblog, a blog devoted to coverage of the Supreme Court of the United States; she continues to serve as an independent contractor and reporter for SCOTUSblog. Before turning to full-time blogging, she served as counsel in over two dozen merits cases at the Supreme Court and argued two cases there. From 2004 until 2011, she co-taught Supreme Court litigation at Stanford Law School; from 2005 until 2013, she co-taught a similar class at Harvard Law School. She has also served as an adjunct professor at American University’s Washington College of Law and Vanderbilt Law School. Amy is a graduate of the University of North Carolina at Chapel Hill and holds a master’s degree in Arab Studies and a law degree from Georgetown University.
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