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An appeals court should reject government officials' request for expedited consideration of their attempt to overturn rulings that struck down Medicaid work requirements in Arkansas and Kentucky, advocacy groups that successfully challenged the requirements argued on Monday.

In filings with the U.S. Court of Appeals for the District of Columbia Circuit, attorneys with the National Health Law Program, Southern Poverty Law Center and Kentucky Equal Justice Center said the cases don't meet the criteria for speedy review spelled out in the appeals court's procedures handbook.

According to the handbook, such requests are granted "very rarely" and only when a delay would "cause irreparable injury" or when "the public generally, or in which persons not before the Court, have an unusual interest in prompt disposition. The reasons must be strongly compelling."

Such expedited consideration isn't meant to "give the government an E-Z Pass through the courts of appeals any time federal agency action is invalidated or generally to privilege the government's cases above all others in the queue," the plaintiffs' attorneys wrote.

The appeal by the federal government and two states challenges U.S. District Judge James Boasberg's rulings on March 27 finding that President Donald Trump's administration violated the law governing Medicaid when it approved the work requirements.

The ruling kept Kentucky's requirement from going into effect and prevented Arkansas from terminating the coverage of thousands of enrollees who didn't meet its requirement during the first three months of this year.

In arguing for expedited consideration of the appeal, attorneys with the U.S. Department of Justice, representing the federal Department of Health and Human Services, said Boasberg's rulings had disrupted demonstration projects in the two states.

The Justice Department attorneys said Boasberg's rulings also created uncertainty about whether work requirements in other states would also be thrown out.

Attorneys for the plaintiffs responded Monday that Section 1115 of the Social Security Act, which the Trump administration used to issue waivers that allowed the work requirements, "was never intended to be a source of authority to bypass Congress and effect changes on a national scale, much less in a way that (as Judge Boasberg correctly recognized) strikes at the heart of the Act."

"The government's contention that [Boasberg's rulings] threaten their cookie-cutter waivers in Arizona, Indiana, Michigan, New Hampshire, Ohio, Utah and Wisconsin is admission that [Health and Human Services Secretary Alex Azar] was not approving 'experiments,' but was instead invoking his waiver authority to 'transform' a congressionally enacted program," attorneys for the plaintiffs wrote.

The plaintiffs' attorneys also said that the case doesn't involve national security, the military or other issues which typically warrant expedited consideration and that the administration is seeking "massive disruption, not continuity" in the Medicaid program.

Arkansas' work requirement, the first ever implemented for a state Medicaid program, resulted in 18,164 enrollees losing coverage last year and in January.

To stay in compliance, enrollees had to spend 80 hours a month on work or other approved activities, unless they qualified for an exemption, and report what they did using a state website or over the phone.

Those who failed to meet the requirement for three months during a year were kicked off the program and barred from re-enrolling for the rest of the year.

The requirement applied to enrollees in Arkansas Works, which covers people who became eligible for Medicaid when the state expanded it in 2014 to cover people with incomes of up to 138 percent of the poverty level.

This year, the income cutoff is $17,236 for an individual or $35,535 for a family of four.

According to figures released Monday, 240,177 people were enrolled in Arkansas Works as of April 1, an increase of 4,215 people compared to a month earlier.

Federal officials have argued that work requirements promote the fiscal sustainability of Medicaid by prodding enrollees to find jobs and move off the program. They also argue that people who work tend to be healthier than those who are unemployed.

Boasberg said in his ruling that the Health and Human Services Department didn't weigh those potential benefits against the harm that kicking people off of Medicaid for noncompliance would cause to their health and the program's goal of providing health coverage.

The lawsuits in both states were filed on behalf of several Medicaid enrollees. Jonesboro-based Legal Aid of Arkansas helped represent the plaintiffs in the Arkansas case along with the National Health Law Center and Southern Poverty Law Center.

A response by the Trump administration to the plaintiffs' arguments against expedited consideration is due Wednesday.

Metro on 04/16/2019

Print Headline: In filing, appeal's urgency disputed

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