Judge James Boasberg, of the U.S. District Court of the District of Columbia, concluded that in letting Kentucky go forward with its requirements, HHS had been "arbitrary and capricious" - the same criticism he leveled once before. He wrote that he "cannot concur" that Medicaid law leaves the HHS secretary "so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose."