A federal judge on Friday blocked Kentucky’s closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage.

The state had been poised to start carrying out the new rules next week and to phase them in fully by the end of this year.

Judge James E. Boasberg of Federal District Court for the District of Columbia, an Obama appointee, ruled that the Trump administration’s approval of the plan had been “arbitrary and capricious” because it had not adequately considered whether the plan would “help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

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The CMS is ratcheting up scrutiny of state Medicaid programs.

The agency announced Tuesday that it is boosting audits to confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.

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Michigan Gov. Rick Snyder (R) on Friday signed a bill to impose controversial work requirements on Medicaid recipients.

If the plan is approved by the Trump administration, Michigan would become the fifth state to add work mandates to its program.

In January, Trump officials released their guidelines for work requirements on Medicaid, a move that has drawn a sharp outcry from Democrats, who say the change will lead to people losing health coverage.

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Sandy Dowland has been to the emergency room 10 times in the past year and was hospitalized during four of those visits. She has had a toe amputated and suffers from uncontrolled diabetes, high blood pressure, major depression, obesity and back pain.

But her health is not high on the 41-year-old woman’s priority list.

“I have a lot going on,” said the unemployed mother of five who lives in a homeless shelter. She said it’s a struggle just to get herself and children through each day.

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Growth in state spending on the Medicaid program is expected to fall significantly in the short term, according to a new report by state budget officers.

The findings, published Thursday in a report from the National Association of State Budget Officers, or NASBO, show that state Medicaid spending is expected to carry a median growth rate of 4.5 percent in fiscal 2018, and then growth is projected to slow significantly in fiscal 2019, to a median growth rate of 1.5 percent. The organization uses governors’ budgets in making its assessments.

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The Republican-led Michigan Legislature on Thursday gave final approval to a bill requiring able-bodied adults in the state’s Medicaid expansion program to meet work or job-related requirements, sending it to Gov. Rick Snyder for his expected signature.

Starting in 2020, adults age 18 to 62 would have to show workforce engagement averaging 80 hours a month — through work, school, job or vocational training, an internship, substance abuse treatment or community service. Michigan would first seek a federal waiver to implement such requirements that have been embraced by President Trump’s administration.

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Gov. Ralph Northam (D-VA) signed a bill into law Thursday that will allow more people to sign up for health care coverage paid for by the Medicaid program. This is projected to move 400,000 low-income residents onto the program. Lawmakers arrived at a compromise on Medicaid and on other parts of spending in part by setting a tax on hospitals. Under Obamacare, the federal government paid for all of the cost of Medicaid expansion in states beginning in 2014, but this support will fall to 90 percent of costs by 2020. In some states, that will mean billions of dollars in additional spending.

Utah voters will decide on ballot measures to expand Medicaid and to legalize medical marijuana this fall.

Lt. Gov. Spencer Cox released Tuesday what measures will be on the ballot in the 2018 elections this November.

A measure to expand Medicaid under Obamacare got enough signatures to make it onto the ballot.

Activists behind the measure are hoping to have the same success as Maine, which approved the Medicaid expansion in a ballot measure last year. However, Republican Maine Gov. Paul LePage has vowed to not abide by the ballot measure, prompting a lawsuit.

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Virginia is on the cusp of expanding Medicaid after the Senate on Wednesday narrowly approved a budget that would allow the state to cover as many as 400,000 low-income people.

The House, which already voted in favor of expansion earlier this year, will have to vote again before the bill can go to Gov. Ralph Northam (D). Northam has made expansion one of the top priorities of his administration.

When it passes, Virginia will become the 33rd state, along with Washington, D.C., to expand Medicaid under ObamaCare.

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A Maine state judge said Thursday that Gov. Paul LePage’s administration has a “duty to enforce” a voter-passed law to expand Medicaid to low-income adults.

Kennebec County Superior Court Justice Michaela Murphy’s comment came during oral arguments in a lawsuit brought by advocacy groups to force the LePage administration to implement the Medicaid expansion overwhelmingly passed by Maine voters last November.

The judge did not indicate when she would issue a ruling, though it’s expected she will rule within a week or so. The losing side is almost certain to appeal.

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