On Wednesday, March 28, U.S. District Court judge James Boasberg struck down the Trump administration's Medicaid work requirement waivers in Kentucky (for the second time) and Arkansas, saying the rules requiring low-income people to prove they are employed "cannot stand." His ruling rippled out to two more states, Idaho and Iowa, and nipped their legislatures' efforts to impose the same requirements.

In the Kentucky case, Boasberg concluded that by letting the state go forward with its program, the Department of Health and Human Services had been "arbitrary and capricious," the same criticism he stated when sending it back to HHS to fix the first time. He wrote that he "cannot concur" that the Medicaid statute leaves the HHS secretary "so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose." In the Arkansas case, he nullified the federal basis the state claimed to add work requirements. This will force Arkansas to stop enforcing the requirement, pending further HHS action to fix it.

The effect in Idaho was dramatic. A state senate committee was literally hearing testimony from citizens and advocates on how and whether to move forward with work requirements to the voter-approved Medicaid expansion initiative when the decisions were handed down. The committee decided almost immediately to kill the existing bill, and the future of Medicaid expansion and these requirements remains uncertain. The work requirements, modeled largely after Arkansas’, are dead. A second proposal that might still be viable would create a voluntary job training requirement for the expansion population, a totally acceptable alternative to advocates and leaders of the initiative campaign. Gov. Brad Little has said that the legislature must remain in session (it was scheduled to leave his week) until a Medicaid expansion bill is passed.

Iowa legislators are abandoning a work requirements bill, not just because of the decision Wednesday, but because state fraud investigators suggested that it and two related bills that would pick on poor people getting public assistance weren't necessary. Go figure: There's at least one Republican legislator whose purpose in life is not gratuitously making poor people's lives hell.