On October 31, 2019, in the face of a federal lawsuit, the Indiana Family and Social Services Administration suspended its enforcement of work requirements under the state’s Medicaid waiver project, the Healthy Indiana Plan (HIP). In 2018, CMS approved Indiana’s request to impose mandatory work requirements as a condition of coverage. The approval followed CMS’s announcement of a new waiver policy supporting the inclusion of “work or other community engagement requirements” in demonstration projects authorized under Section 1115 of the Social Security Act.
Indiana began implementing its work requirements on January 1, 2019 as part of its Gateway to Work program. Prior to the suspension, HIP enrollees were required to meet escalating monthly time requirements for qualifying activities. If an enrollee failed to meet the work requirements for more than four months of a year, the individual’s benefits would be suspended beginning on the first day of the next year. The suspension would last until the enrollee completed the required hours for one month, qualified for an exemption, or was terminated from the HIP through a redetermination process. Gateway to Work exempts certain categories of enrollees based on qualifying health, education, and other factors (e.g., pregnancy, medical frailty, 60 years of age and older).
The plaintiffs in the lawsuit are asking the D.C. District Court for declaratory and injunctive relief, arguing HHS violated the Administrative Procedure Act when it approved Indiana’s request to impose the work requirements because, among other reasons, the new waiver policy did not go through proper notice and comment rulemaking and exceeds the scope of the agency’s Section 1115 waiver authority. Previously, the D.C. District Court issued opinions blocking Arkansas, Kentucky, and New Hampshire from implementing similar work requirements. All three states have appealed the rulings to the U.S. Court of Appeals for the D.C. Circuit.
The Indiana case is Rose, Jr. v. Azar, Case No. 1:19-cv-02848, and the complaint is available here.
