Federal Judge Throws Out Arkansas' Medicaid Work Requirements

AUDIE CORNISH, HOST:

From Medicaid to challenges to the Affordable Care Act, health care and access to it seems to be the theme of the week. In a moment, we'll hear how a federal lawsuit challenging the ACA could roll back protections for people with preexisting conditions. But we begin with Medicaid, the federal health insurance program for low-income people.

The state of Arkansas had instituted a work requirement for people enrolled in that program. Kentucky was attempting to implement one. Well, yesterday, a federal judge blocked those requirements for both states. Kevin De Liban, a lawyer for people in Arkansas's Medicaid program, says his clients are breathing a sigh of relief.

KEVIN DE LIBAN: Because they knew that they would wake up tomorrow, and the week after, and still have health insurance.

CORNISH: Cindy Gillespie is the director of the Arkansas Department of Human Services. They oversee Medicaid in Arkansas. Welcome to the program.

CINDY GILLESPIE: Hi. Good to be here.

CORNISH: So to begin, what does this ruling mean right now? As of this moment, is the work requirement dead in Arkansas?

GILLESPIE: For right now, the work requirement is not in effect as of the judge's ruling. So we have - I think the judge used the term hit pause.

CORNISH: Something like 18,000 people had lost coverage under the existing rules of the work requirements. What are you going to do to reach out to those folks?

GILLESPIE: Those individuals were all contacted last year, and they have all been eligible to re-enroll since January of this year.

CORNISH: But only like a thousand of them have. I mean, is there a concern that there is a gap?

GILLESPIE: The fact that they lost Medicaid coverage does not necessarily mean that they lost medical coverage. Some of the individuals have found jobs. Some may have moved out of state. No longer being in Medicaid coverage does not mean that they are necessarily uninsured.

CORNISH: The governor of your state, Asa Hutchinson, has said that he isn't giving up the fight on the work requirement. I notice you cited the judge's word, pause, in the program. Do you expect the state to fight this?

GILLESPIE: The governor's indicated to both the Department of Justice, as well as to HHS, that we will support an appeal and really urge them to seek an expedited appeal.

CORNISH: The federal judge who ruled in this case specifically said that the purpose of Medicaid is to provide health care. It's not about lifting people out of poverty. What's your response to that?

GILLESPIE: We do believe, very strongly, that the purpose of Medicaid is to help people attain health and attain a healthy life. And part of having a healthy life is actually to be engaged. All the studies show the social determinants of health are mostly tied to poverty - where you have to live, your education, your background. All of those pieces are part of your health.

CORNISH: The judge also specifically said that the state's outreach efforts may be falling severely short, he noted, and talked about the state using this time during this pause to better educate people about the requirements and how to satisfy them. Is that something you all are taking on board? What changes are you think of making?

GILLESPIE: At this stage, our education efforts are going to continue focusing on helping individuals understand the services that are available there to help them with these other areas. So as part of informing them that they are, you know, now eligible and inside a Medicaid program, and they're going on an insurance policy and how to use that.

We're also going to talk to them about the services available to help them find a job, or help them get a GED, or help them build a better life, and therefore help them with all the activities connected to their health.

CORNISH: This program was being eyed as a model around the country. What message do you think this ruling sends to those states who are thinking about a work requirement similar to the one in Arkansas?

GILLESPIE: You know, it's always hard being the first to do something. I think the primary message is that it is our intention to work very closely with HHS and with DOJ and hopefully be successful in future legal action in this area. But we've got good lessons learned around outreach and education and the positives that come as you begin to connect this population more to the services. And we will continue to share those with those states.

CORNISH: Cindy Gillespie is the director of the Arkansas Department of Human Services. Thank you for speaking with ALL THINGS CONSIDERED.

GILLESPIE: Thank you.

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