Advocacy groups filed the first lawsuit challenging the Trumpadministration’s efforts to overhaul Medicaid by allowing states to requiresome beneficiaries to work or pursue jobs.

The suit, filed in federalcourt in Washington on behalf of more than a dozen Kentucky Medicaid recipients, seeksclass-action status to halt changes to the state’s Medicaid programthat the administration approved this month. It says the changes gobeyond what’s allowed under current Medicaid law and regulationsand were imposed without following appropriate governmentprocesses.

Kentucky was the first state cleared to shift its Medicaidprogram in a more conservative direction, after the Centers forMedicare and Medicaid Services said this month it would let statesrequire some Medicaid recipients to prove they are working,training for a job, or volunteering as a condition of gainingcoverage.

Nine other states have asked Washington to let them make similarchanges, adding to the significance of the first legalclash.

In Kentucky, about 1.3 million people are covered by Medicaid,after the state expanded eligibility under the Affordable Care Actunder a Democratic governor. Republican Governor Matt Bevin,elected in 2015, has been pushing to reduce the rolls. He said inan interview after the changes were approved that work requirementsfit with the purpose of Medicaid.

“If you read what the purpose of Medicaid is, it’s to get peopleengaged and to create work opportunities,” Bevin said in a Jan. 16interview. “When Medicaid was originally designed, it was designedto help assimilate disabled people back into society to theabsolute extent possible, to create work opportunities. These aresome of the underlying tenets of Medicaid for the traditionalMedicaid population."

Bevin signed an executive order on Jan. 12 saying he wouldreverse the state’s expansion of Medicaid if a court strikes downany portion of Kentucky’s waiver application, once appeals areexhausted.

About 350,000 Kentuckians would be subject to the workrequirements, according to the state’s waiver application. In fiveyears, the plan is expected to reduce Kentucky’s Medicaidenrollment by about 95,000 and save $2.4 billion.

The groups bringing the suit are the National Health LawProgram, Kentucky Equal Justice Center and the Southern Poverty LawCenter.

Leonardo Cuello, the director of health policy for the NationalHealth Law Program, said the Trump administration is oversteppingits legal authority.

“This abuse of authority cannot go unchecked, and we expect acourt to step in and protect rule of law in America and the healthof Kentuckians,” Cuello said in an email.

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