Judge Blocks Work Requirements for Medicaid Recipients in Arkansas and Kentucky

WASHINGTON — A federal judge on Wednesday threw out Medicaid work requirements in two states that had been approved by the Trump administration. He rejected for a second time Kentucky’s attempt to require recipients to work or volunteer as a condition of coverage and blocked a similar rule in Arkansas, which has resulted in more than 16,000 people there losing coverage since last fall.

The twin rulings are a blow to the Trump administration, which has allowed eight states to begin requiring many of their Medicaid recipients to work, volunteer or train for a job to be eligible for benefits. Eight other states are seeking permission from the Department of Health and Human Services to impose similar rules.

The judge, James E. Boasberg of Federal District Court for the District of Columbia, had already ordered H.H.S. to re-evaluate Kentucky’s work requirement in a ruling last June.

In his new ruling, Judge Boasberg, an Obama appointee, found the approval of Arkansas’s work requirement by Alex M. Azar II, the health and human services secretary, was “arbitrary and capricious” for a similar reason. Mr. Azar had failed, he wrote, to “consider adequately” the impact of Arkansas’s plan on Medicaid coverage.

“The court finds its guiding principle in Yogi Berra’s aphorism, ‘It’s déjà vu all over again,’” Judge Boasberg wrote.

Arkansas officials had asked the judge to leave the work requirements in place in the event that he ordered Mr. Azar to further weigh their potential impact, saying that freezing them would cause too much disruption.

The judge disagreed, writing that “the road to cure the deficiency in this case is, at best, a rocky one” and that any disruption “must be balanced against the harms that plaintiffs and persons like them will experience if the program remains in effect.”

In the Kentucky case, Judge Boasberg said the state’s plan, with only minor changes since his last ruling, “has essentially the same features as it did before.” He said that Mr. Azar’s review and approval of the Kentucky program were fatally flawed because federal officials did not adequately consider “the coverage-loss consequences” of the work requirements.

The rulings presented a serious setback not only for President Trump and Mr. Azar, but for the federal official in charge of the Medicaid program, Seema Verma, who has led the call for conditioning health coverage for low-income Americans on work.

She has insisted that Medicaid must not be “used as a vehicle to serve working age, able-bodied adults.” And she affirmed her goals Wednesday evening after the latest rulings came out.

“We will continue to defend our efforts to give states greater flexibility to help low income Americans rise out of poverty,” Ms. Verma said. “We believe, as have numerous past administrations, that states are the laboratories of democracy and we will vigorously support their innovative, state-driven efforts to develop and test reforms that will advance the objectives of the Medicaid program.”