On January 24, 2018, several Kentucky residents enrolled in the Kentucky Medicaid Program filed this lawsuit in the U.S. District Court for the District of Columbia. The plaintiffs sued the Secretary of the United States Department of Health and Human Services (“HHS”) under the Administrative Procedure Act (APA). The plaintiffs, represented by the National Health Law Program, the Kentucky Equal Justice Center, and the Southern Poverty Law Center, sought declaratory and injunctive relief as well as attorneys’ fees and costs. The case was assigned to Judge James E. Boasberg.

On August 24, 2016, Kentucky Governor Matt Bevin submitted an application under Section 1115 of the Medicaid Act to the defendant requesting a waiver of various Medicaid Act requirements to implement the “Kentucky HEALTH” project, which required Medicaid enrollees to work in order to receive health insurance and imposed new and substantial premiums and restrictions. The defendant filed a letter of approval of this waiver. The plaintiffs claimed that in doing so, the defendant made an unauthorized attempt to rewrite the Medicaid Act and violated the APA.

The defendant filed a motion to transfer the case to the U.S. District Court for the Eastern District of Kentucky, arguing that because all plaintiffs lived in Kentucky, justice and convenience suggested a strong interest in adjudicating a primarily local controversy in a local forum. On April 10, 2018, however, Judge Boasberg denied this motion, reasoning that both private- and public-interest factors weighed against transfer.

On March 29, 2018, Governor Bevin, on behalf of the Commonwealth of Kentucky, filed an unopposed motion to intervene as to defend his Section 1115 waiver. The court granted this intervention and the Commonwealth intervened as a defendant.

On March 30, 2018, the plaintiffs moved for summary judgment, arguing that the defendant Secretary lacked the authority to fundamentally restructure Medicaid through the approval of Kentucky HEALTH. The plaintiffs further argued that the Secretary’s approval of the Kentucky HEALTH provisions both exceeded statutory authority and was arbitrary and capricious.

On April 25, 2018, both the defendant Commonwealth and defendant Secretary filed separate motions for summary judgment. The Commonwealth argued that the plaintiffs lacked standing, that their arguments about the scope of Section 1115 and Medicaid’s objectives were demonstrably wrong, and that the Secretary validly approved Kentucky HEALTH’s provisions. The Secretary argued that Section 1115 of the Social Security Act vested in him broad discretion to approve state projects and that he complied with all APA standards. The Secretary further argued that both the plaintiffs’ challenge to the individual components of Kentucky HEALTH and their challenge to the Secretary’s approval letter were non-justiciable and failed on their merits.

The case is ongoing. As of June 2018, the court has yet to rule on any of the three pending motions for summary judgment.

Jake Parker - 06/08/2018


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