A federal judge has blocked Medicaid work requirements approved by the Trump administration in Arkansas and Kentucky after more than 18,000 people have already lost coverage.

Judge James Boasberg of the U.S. District Court for the District of Columbia, an Obama appointee, ruled Wednesday afternoon in two separate cases that the Trump administration didn't consider whether the work requirements met the objective of Medicaid: to provide coverage to needy populations.

It's the second time Boasberg has rejected the Kentucky program, which has not yet taken effect, and sent it back to the Department of Health and Human Services (HHS) for changes. It's the first time the Arkansas program has been struck down in court. More than 18,000 people have lost coverage since the program took effect last summer.

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HHS, under the leadership of Secretary Alex Azar, approved the programs, arguing that it improves health outcomes by encouraging people to work.

But Boasberg wrote in his decisions Wednesday that the Trump administration did not meet Medicaid's purpose of providing health insurance to the needy.

"Rather than adequately addressing Kentucky HEALTH's potential to cause loss of medical coverage, the secretary continues to press his contention that the program promotes his alternative proposed objectives of beneficiary health, financial independence and the fiscal sustainability of Medicaid," Boasberg wrote in the Kentucky opinion.

"The Secretary's failure once again to adequately consider the effects of Kentucky HEALTH on coverage is alone ... fatal to approval," he wrote.

He cited similar reasoning in his Arkansas opinion, writing that Azar's approval of the work requirements was unlawful because it didn't consider potential coverage losses.

HHS originally approved the Kentucky program last summer, but it was blocked by Boasberg, who said Azar didn't adequately consider its impact on coverage.