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Medicaid Enrollees Cut off Critical Health Benefits During COVID Public Health Emergency Due to Lawless Trump Administration Regulation Seek Nationwide Class Certification and Injunction

Media Contact: Bernard Kavaler for Disability Rights Connecticut: 860-729-3021 bernard@express-strategies.com

Five Plaintiffs from Three States seek to represent others affected throughout the U.S. and ask for nationwide preliminary injunction to stop ongoing harm

August 26, 2022—Today, low-income disabled and older adult plaintiffs in Connecticut, Delaware, and Nebraska filed an amended complaint and a formal request for certification of a nationwide class seeking nationwide preliminary and permanent injunctive relief against the United States Department of Health and Human Services (HHS), for failing to rescind an illegal rule the Trump Administration issued just before leaving office. The rule requires states to trim their Medicaid rolls as a condition of receiving additional funds to combat the COVID-19 pandemic, in clear violation of Congress’ mandate to ensure continued access to Medicaid-funded health care throughout the ongoing public health emergency, as provided in the Coronavirus Response Act passed by it in March of 2020.

One new plaintiff, a 65-year-old Nebraska woman, lost access to full Medicaid services in the midst of cancer treatment because she turned 65. She was notified in December of 2021 she was losing access to Medicaid even though the state had recently notified her in June of that year that she remained eligible. She originally qualified for Medicaid due to her low income as part of Nebraska’s Medicaid expansion, and, as a result, was, for the first time in many years, able to see a dentist and deal with long-term oral health needs. She also was able to receive hip surgery and therapy that allowed her to walk, and receive treatment for emphysema and high blood pressure. Since her full Medicaid services have been terminated, she cannot afford required Medicare co-insurance payments for her doctor visits or to pay for dental care (not covered at all by Medicare) out-of-pocket, and she has forgone treatment for some conditions and is concerned about accruing even more medical debt for others.

Another new plaintiff, a 73-year-old woman in Delaware, lives entirely on her small Social Security benefits. She has multiple long-term serious health issues including rheumatoid arthritis (RA), COPD, high blood pressure, and an artery occlusion. Due to her low-income, she qualified for help with cost-sharing for these treatments through the Qualified Medicare Beneficiary Program (part of Medicaid). In March of this year, she was notified by the state that she would no longer qualify for this program because the Social Security Cost of Living Adjustment put her $1 over the limit. It is now difficult to afford the regular infusions to treat her RA that her doctor recommends, which are $478 per treatment. A scan this past spring showed possible cancer in her lungs, and her pulmonologist recommends further screening, but she cannot afford this.

The original lawsuit was filed in U.S. District Court in Connecticut by three Connecticut plaintiffs in early August citing the impact of the rule on at least 6,600 plaintiffs in the state who lost access to Medicaid benefits as a result of the rule.  Two of the three plaintiffs are facing forced institutionalization without the Medicaid-funded home care services they rely upon.  Almost immediately after the complaint was filed, following the filing of a motion for a temporary restraining order on their behalf, HHS temporarily restored benefits to these two plaintiffs pending a determination by the court on the plaintiffs’ broader motion for a nationwide preliminary injunction . A hearing is scheduled for September 27th on the preliminary injunction sought on behalf of the hundreds of thousands of others nationwide who have lost access to vital health care during this ongoing pandemic.

The proposed Nationwide class consists of all individuals who were enrolled in Medicaid in any state or the District of Columbia on March 18, 2020 or later and had their Medicaid eligibility terminated or reduced to a lower level of benefits on or after November 6, 2020, or will have their Medicaid eligibility terminated or reduced to a lower level of benefits prior to a redetermination conducted after the end of the Public Health Emergency, for a reason other than moving out of the state or the District (including through death) or voluntarily disenrolling from benefits.

Plaintiffs are represented by Disability Rights Connecticut, Justice in Aging, The National Health Law Program (NHeLP) and the law firm Stinson LLP.

 

 

 

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