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US Supreme Court Declines to Hear Arkansas Medicaid Work and Community Engagement Requirement Case

April 20, 2022

Author

Jennifer Wessel, JD, MPH
Senior Policy Analyst
501-526-2244
JBWessel@achi.net

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On Monday (April 18), the U.S. Supreme Court decided not to reschedule oral arguments in cases involving Medicaid work and community engagement requirements (WCER) in Arkansas and New Hampshire, ruling that the cases are now moot. In its order, the court also granted a motion to vacate a decision by the U.S. Court of Appeals for the D.C. Circuit and instructed the U.S. District Court for the District of Columbia to dismiss the cases as no longer in controversy.

In 2018, Arkansas residents enrolled in Medicaid filed a lawsuit against the Trump administration challenging the WCER approved by the Centers for Medicare and Medicaid Services (CMS). The D.C. district court found that the proposed requirement did not meet the primary objective of Medicaid to provide medical assistance, and the D.C. appeals court affirmed the district court’s ruling.

In March 2021, the Supreme Court agreed to review the case, joined with a similar appeal from New Hampshire. The high court scheduled the cases for oral arguments, but the cases were later removed from the calendar after the Biden administration signaled it would withdraw waiver approval for work-related requirements.

On March 17, 2021, CMS withdrew its approval of a WCER as a condition of eligibility for Arkansas’s Medicaid expansion program. In addition, the approval of Arkansas’s work-related requirements expired by its own terms on Dec. 31, 2021.

The decision to dismiss the cases and vacate the lower-court decisions leaves open the door for future administrations to interpret Medicaid objectives broadly and to offer states considerable flexibility for incorporating unique features into waiver applications.

For more information on policy decisions and coverage impacts related to the Affordable Care Act in Arkansas, see our updated timeline.