How Kentucky’s 1115 Medicaid Work Demonstration Undermines Health Coverage
<p>Earlier this month, Kentucky became the first state to gain approval to launch a demonstration that will make employment an eligibility requirement for Medicaid. Shortly after the U.S. Department of Health and Human Services (HHS) gave the green light to the state's proposal, attorneys representing 15 Kentucky Medicaid beneficiaries sued the HHS secretary, seeking to have the Trump administration's work policies declared unlawful.</p><p>On <em>To the Point, </em>Sara Rosenbaum of George Washington University and colleagues examine the heart of the case: that the demonstration may exceed the HHS secretary’s power under Section 1115, because it runs counter to Medicaid's core objective — to promote access to medical assistance among the nation’s neediest populations so that they can gain health and independence. The authors also highlight unanswered implementation and evaluation questions. </p>
<p>“Kentucky is one of the nation's poorest states, and its health insurance coverage gains following its Medicaid expansion led the nation,” the authors say. “But this demonstration threatens to unwind these gains.” </p>