Feds to reopen Medicaid plan for public comment; state officials say they haven’t decided on appeal of judge’s ruling against it

By Al Cross Published July 23, 2018 HEALTH POLICY

Federal officials say they will hold another round of public comment on the Kentucky Medicaid plan that was blocked by a federal judge and sent back to them for more review. Meanwhile, state officials told legislators that they’re working “toward a re-approval” of the plan and haven’t decided on an appeal.

The Centers for Medicare and Medicaid Services plans to announce the 30-day comment period, “allowing the administration to potentially show it’s addressing the court’s concerns” that Kentuckians would lose coverage, Politico reports.

U.S. District Judge James Boasberg of Washington, D.C., vacated the Department of Health and Human Services‘ approval of the plan on June 29, saying HHS had not adequately considered the state’s estimate that its Medicaid rolls would have 95,000 fewer people with the plan than without it — in large measure for non-compliance with its requirements.

The plan would require “able-bodied” adults who are not primary caregivers to work, take job training or volunteer 80 hours a month, or enroll in drug-treatment program. Kentucky was the first of four states where HHS approved such requirements. The plan also includes small monthly premiums based on income.

“Trump administration lawyers are said to be confident that the strategy will allow them to surmount” Boasberg’s concerns, but “advocates and external observers have doubts,” Politco reports. Boasberg “specifically criticized HHS Secretary Alex Azar for disregarding public comments that were overwhelmingly against the plan.”

A new comment period “could allow the administration to address the judge’s concerns,” politico notes. “Reopening the comment period would permit the inclusion of new material — such as a White House report touting work requirements in safety-net programs, which was released last week — that could substantiate the administration’s arguments that they’re considering evidence on the plan’s impact. CMS also could use the comment period to revise its plan so it’s better protected against further legal challenges.”

Gov. Matt Bevin has said the Supreme Court will ultimately decide the issue, but officials of the state Cabinet for Health and Family Services told the General Assembly’s Medicaid Oversight Committee Wednesday that the Bevin administration has not decided whether to appeal Boasberg’s ruling. Normally, such appeals must be filed within 30 days.