Kentucky’s plan to impose Medicaid work requirements is being re-challenged in court, after it was re-approved by the Trump administration this past November.

Flashback: Kentucky was the first state to win approval for Medicaid work requirements last year.

A federal judge stopped those rules from taking effect, saying the Health and Human Services Department hadn’t made a compelling enough case that work requirements align with Medicaid’s stated purpose.

In response, HHS reopened the window for public comments on Kentucky’s proposal, then quickly re-approved basically the same policy.

A new class-action lawsuit filed on behalf of 16 Kentuckians says the re-approval is still illegal.

It accuses HHS of "working to effectively rewrite the Medicaid statute, ignoring congressional restrictions, overturning a half century of administrative practice, and threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country."

The big picture: Medicaid work requirements are arguably the most substantively significant piece of health policy the Trump administration has implemented.

The policy would substantially curb enrollment — Kentucky estimates more than 90,000 people would lose their coverage there — and help redefine a health care program as a form of welfare.

Go deeper: Kentucky's health care microcosm