- Associated Press - Wednesday, January 24, 2018

FRANKFORT, Ky. (AP) - Fifteen people in Kentucky who get their health insurance through Medicaid have sued the federal government, asking a judge to block new first-in-the-nation rules that would make them work to keep their taxpayer-funded benefits.

The lawsuit , filed Wednesday in the U.S. District Court for the District of Columbia by three nonprofit groups, is the first legal challenge of a Medicaid waiver granted by the Trump administration.

The federal government announced earlier this month it would let Kentucky be the first state to require many of its Medicaid recipients to have a job or do volunteer work in order to keep their health coverage. The waiver would also charge monthly premiums and lock people out of their coverage for six months if they fail to notify state officials of changes in their employment and income.

State officials expect the new rules will cause 95,000 people to lose their Medicaid coverage for a variety of reasons over the next five years. And in an unusual pre-emptive move, Republican Gov. Matt Bevin has signed an executive order that would repeal the state’s expanded Medicaid program if any part of the new rules is struck down in court. If that happens, it would end health coverage for more than 400,000 people.

“We will not be intimidated. We will defend the rights of individuals to enroll in Kentucky’s Medicaid program,” said Samuel Brooke, deputy legal director for the Southern Poverty Law Center, which filed the lawsuit along with the National Health Law Program and the Kentucky Equal Justice Center.

The lawsuit names acting Health and Human Services Secretary Eric Hargan, who visited with Bevin at the Kentucky Governor’s Mansion on Wednesday and spoke with a few reporters after their meeting.

“We believe it’s a solid program. We think it’s solid legally,” Hargan said. “We will await the result in court.”

Congress created Medicaid in 1965 for families on welfare and low-income seniors. But the program has grown to become the nation’s largest health insurance program, covering about 1 in 5 Americans.

In Kentucky, the program had explosive growth after former President Barack Obama’s health care law extended coverage to able-bodied adults with no children. Medicaid now covers more than a quarter of the state’s population.

Bevin and other Republican leaders say the state can’t afford that. He said it is his goal for Medicaid to be covering 95,000 fewer people in five years, because that means those people will have gotten jobs that pay them so much money they are not eligible for Medicaid anymore.

“Nobody will be removed at all. Nobody. Some will choose not to participate and some will chose to participate and will ride this thing right out of Medicaid, and that’s exactly what it is there for,” he said.

But Ronnie Stewart says it is more complicated than that. The 62-year-old former social worker lost his job a few years ago. He struggled to find work, moving to several states and becoming homeless for a while. Eventually he landed a job at the University of Kentucky Hospital, working to sterilize rooms and equipment.

“I just kept trying. I didn’t give up,” said Stewart, who was one of the 15 people to file the lawsuit.

But he wasn’t fast enough to keep up with the physical demands of his job, and now he is unemployed. His sole income is $841 a month in Social Security retirement benefits. He’s worried he won’t be able to find a job so he can log the required 80 hours a month to keep his Medicaid benefits.

“I worked all my life. I paid in to social security, I paid taxes all of my life. I didn’t just lay around. I worked,” he said. “But it’s hard for somebody in their 60s to find a job.”

Bevin noted there are multiple ways for people to meet the new requirements other than getting a job. He said they could volunteer, take a job-training course or go back to school. Plus the work requirement has a number of exemptions, including the medically frail, a broad term that includes people struggling with mental illness and drug and alcohol addiction.

“Don’t get hung up that somehow if they are not working that’s it. There are multiple onramps for a reason,” Bevin said. “Those who choose not to, we have no control over.”

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