Supreme Court nixes appeal on Arkansas' Medicaid work requirements program

By Robert King / April 18, 2022

The Supreme Court has shot down a case surrounding the legality of Medicaid work requirements, sending the case back to a lower court with instructions to dismiss it entirely.

The decision on Monday in Becerra vs. Gresham comes more than a year after the court canceled oral arguments in the work requirements case in March 2021. While a major policy priority for the Trump administration, President Joe Biden’s Centers for Medicare and Medicaid Services has moved to unwind the requirements.

The Supreme Court remanded the case during back to the U.S. Court of Appeals for the District of Columbia, alongside instructions to dismiss the case as moot. Justices did not elaborate further on the reasons behind the decision, which was included in a list of orders on Monday.

Justices decided to take up the case surrounding Arkansas’ Medicaid work requirements program back in December 2020. A federal judge had struck down the program that required certain Medicaid beneficiaries to meet work requirements to keep their coverage.

An appeals court agreed with the lower court’s ruling that the state's work requirements program did not meet the goals of Medicaid, which is to provide coverage to low-income Americans.

Work requirements were a major policy priority for former President Donald Trump’s CMS, with the agency asking states to apply for waivers to install the policy.

While the agency argued the requirements should only apply to able-bodied beneficiaries that got coverage under the Affordable Care Act’s Medicaid expansion and were needed to help preserve state Medicaid budgets, opponents countered the requirements were a thinly veiled attempt to cut benefits.

Opponents held up Arkansas as a prime example, noting that more than 18,000 people lost coverage in the state because of confusion over how to report eligibility for the work requirements. 

CMS granted waivers to more than a dozen states. However, legal challenges stymied most of the programs from taking effect.

The Biden administration asked the Supreme Court to nix the work requirements case back in February 2021. The Department of Health and Human Services wrote to the court that it was looking into withdrawing the waivers and was worried about the potential loss of insurance coverage amid the COVID-19 pandemic.

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