This opinion piece appeared in The Hill, you can read the full piece here.

Members of Congress have famously failed to fulfill campaign promises to repair or replace the Affordable Care Act. Those unfulfilled promises have left states looking for new ways to fix their broken health-care systems. As Congress hems and haws on health care reform, states have been lining up to ask the Trump administration for administrative relief under the ACA’s innovation and Medicaid 1115 waivers.

Too often, executive branch offices have denied or unduly delayed those requests. And now the federal judiciary has joined Congress and the administration in blocking states from enacting commonsense health care reforms. A recent decision by U.S. District Court Judge James Boasberg highlights the risks of relying solely on waiver requests and executive branch leniency, and it casts much of the waiver process into legal limbo.

Boasberg’s ruling has stopped Kentucky from implementing its Medicaid waiver program for able-bodied beneficiaries, which the Centers for Medicare and Medicaid had already approved. The key component of Kentucky’s waiver request was a work and community engagement requirement for able-bodied Medicaid recipients, the first to receive federal approval. The Trump administration has encouraged such requirements, and 10 other states, including Ohio, have already filed similar waiver requests with Washington. Michigan is now preparing its own request, and others are doing the same.

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