Medicaid Compelled Work Experiments Represent an Abuse of Research Authority, Have Stripped Thousands of Eligible People of Coverage

WASHINGTON (March 10, 2021) – A public health “friend of the court” brief filed with the U.S. Supreme Court urges the highest court of the land to uphold lower court decisions that blocked Medicaid work requirements in Arkansas and New Hampshire. 

Public health and health policy Deans and Scholars argue that Medicaid compelled work demonstrations violate the foundational principles on which rest the special experimental powers Congress granted the U.S. Department of Health and Human Services. Far from promoting Medicaid objectives, compelled work experiments ignored all research norms, created barriers to coverage that threatened health and health care, and violated the legal authority granted the HHS Secretary.   Amici claim that such experiments, whose harms are self-evident and that were allowed to go forward without basic evaluation safeguards in place, are impermissible. 

Congress enacted the Medicaid program to provide medical assistance to people whose income and resources are insufficient to pay the cost of necessary care. Despite the clear mandate, HHS allowed Arkansas and New Hampshire to compel Medicaid recipients to work or lose their coverage.

“These demonstrations failed the basic precepts on which reasonable experiments rest and were allowed to proceed unchecked in their harm until the courts intervened,” said Lynn R. Goldman, Dean of the Milken Institute School of Public Health at the George Washington University. “Federal research authority must be exercised only after thorough consideration of evidence for potential harms, and whether it is possible to assure the protection of research participants.” 

Dean Goldman and 70 Deans, Chairs and Scholars and experts in health law, public health, and health policy from all over the United States filed the amicus brief in order to inform the Court about the history of the Medicaid demonstration projects and work requirements.  They point out that HHS approved the Arkansas and New Hampshire experiments by ignoring evidence, much of it from the government’s own research, regarding the impact of conditioning eligibility for basic health and human services programs on work. Public health research suggests that such work requirements are unreasonable and can be harmful to human health, according to Sara Rosenbaum, the Harold and Jane Hirsh Professor of Health Law and Policy at the George Washington University Milken Institute School of Public Health. “Section 1115 was never intended to allow the Secretary to place Medicaid beneficiaries in harm’s way.” 

Furthermore, the scholars contend that Medicaid compelled work experiments are arbitrary, capricious and run counter to the intent of Medicaid. “While States have options to expand eligibility and coverage, they cannot impose eligibility or coverage restrictions not authorized by law,” the brief says. 

The Deans, Chairs and Scholars are represented by Edward T. Waters and Phillip A. Escoriaza of the Washington, DC law firm of Feldesman Tucker Leifer Fidell, LLP.

The amicus brief can be accessed here. 

The public health scholars who signed the brief did so in their individual capacities. The views expressed are their own and do not represent the scholars’ affiliated universities.

-GW-