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Voters turn against Medicaid work requirements in Kentucky

The Trump administration and Republicans may really like the idea of making Medicaid recipients work, but voters in Kentucky apparently aren’t so enamored with the idea.

Andy Beshear, Kentucky’s Democratic attorney general who campaigned on rescinding the state’s mandate, is poised to defeat Republican Gov. Matt Bevin, who was the first to receive federal approval to institute work requirements in January 2018.

In his victory speech Tuesday, Beshear promised to take swift action.

“In my first week in office, I’m going to rescind this governor’s Medicaid waiver,” said Beshear, whose father, Steve, expanded Medicaid to low-income adults under the Affordable Care Act when he was governor.

Bevin, who trailed by fewer than 5,000 votes, has asked for a recount.

Kentucky’s work requirement — which mandates that certain low-income recipients work, volunteer, attend job training classes or participate in other activities to receive benefits — has never gone into effect. A federal judge halted the mandate in June 2018, days before it was set to start, after advocacy groups filed a lawsuit arguing that work requirements run counter to Medicaid’s objective of providing the poor with access to health care. Kentucky officials estimated that 95,000 people would lose coverage by the program’s fifth year.

“Add to the growing list of why states should not pursue this policy — voters don’t like them,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University. “Elected officials take note.”

US District Court Judge James Boasberg has also halted work requirements in Arkansas, where more than 18,000 people lost coverage last year after the mandate began, and in New Hampshire. Meanwhile, Arizona and Indiana have halted their programs.

Boasberg’s ruling is now under review by a panel of federal appeals court judges, who sounded inclined to support his decision during oral arguments last month. Bevin has promised to take the case to the Supreme Court if he loses in lower courts.

In Virginia, Democrats took control of the state legislature, leading some experts to speculate the new majority could set aside work requirements there. Democratic Gov. Ralph Northam secured a deal with Republican lawmakers last year to expand Medicaid, but also mandate that certain recipients work.

The state is still negotiating its waiver application with Centers for Medicare and Medicaid Services, which has approved such waivers in nine states so far and has nine under review.

“The governor is looking at all options moving forward — it’s clear from the results last night that Virginians want more access to health care, not less,” said Alena Yarmosky, the governor’s spokeswoman, noting that more than 327,000 residents have gained coverage since Medicaid expansion began in January.

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