House GOP contemplate a push for Medicaid work requirements

House Republicans plan to push work requirements. White House aides say no.

House Republicans are eyeing work requirements in the Medicaid program, hoping to deliver on a long-sought conservative goal.

The move is part of a broader push by the newly empowered party for new work rules for millions of low-income Americans who receive health insurance, money to buy food and other financial aid from the federal government.

The GOP has particularly homed in on two anti-poverty programs: Medicaid, which provides health coverage to some of the poorest Americans, and food stamps, which help purchase groceries for the needy. Prominent Republicans, such as House Speaker Kevin McCarthy (R-Calif.), have publicly endorsed rules that could mean some enrollees must find a job or work longer hours, or risk losing the government’s help. 

The push comes amid a fight over the federal budget, as Republicans have said federal aid programs could be a way for policymakers to boost U.S. labor force participation while saving Washington money. The idea still faces an uphill battle, garnering pushback from the White House, Democrats and aid workers who argue the policies could be harmful to vulnerable Americans.

Expect to hear work requirements come up in the context of the brewing battle over the debt ceiling. That’s the statutory limit on how much the federal government can borrow to pay its bills — and lawmakers must raise that cap as soon as June or risk default.

In a recent letter, McCarthy called on Biden to negotiate. He included in his demands policies “strengthening work requirements for those without dependents,” and cited the fact President Biden had supported the welfare-to-work approach adopted under former president Bill Clinton in the 1990s.

• “This is the perfect time to have work requirements because people are needed, they’re wanted,” said Rep. Brett Guthrie (R-Ky.), the chair of the House Energy and Commerce health subcommittee. “Wages are rising because there’s a shortage of workers, so it’s a good opportunity for people to better themselves moving forward.”

House Republicans haven’t coalesced around exactly what adding a work requirement to the Medicaid program would look like — and the two parties have previously battled over such a mandate in the safety net program. 

In February, Rep. Matt Gaetz (R-Fla.) released legislation that would deny benefits to able-bodied adults unless they work for 120 hours per month, volunteer or participate in a work program for 80 hours, or participate in a combination of those activities. The legislation doesn’t have any co-sponsors, and the congressman’s office didn’t respond to a request for comment. 

Meanwhile, the House Freedom Caucus, a hard-right bloc of Republicans, of which Gaetz is a member, has generally endorsed work requirements. The group didn’t specify any programs, but Rep. Scott Perry (R-Pa.), the caucus’s chair, later told our colleagues at The Early 202 that he wants nationwide work requirements for Medicaid.

Meanwhile … The Supplemental Nutrition Assistance Program, or SNAP, already requires many adults without children to seek employment and training. But GOP leaders contend those rules are too lax and exempt too many beneficiaries. 

One key bill from Rep. Dusty Johnson (R-S.D.), a top ally of McCarthy, would redo some of the program’s rules, particularly by subjecting Americans without children between ages 49 and 65 to additional SNAP work requirements. 

But any such proposals will set up a showdown with the White House, as aides outright rejected the notion of changes to Medicaid and food stamps that reduce enrollment.

• “The President has been clear that he will oppose policies that push Americans into poverty or cause them to lose health care,” White House spokesman Michael Kikukawa said in a statement. “That’s why he opposes Republican proposals that would take food assistance and Medicaid away from millions of people by adding burdensome, bureaucratic requirements.”
• In an interview last month, Biden’s Medicaid chief was critical of work requirements. “On work requirements, I think the administration’s position is really clear about being very much concerned about putting up barriers to people getting coverage,” said Chiquita Brooks-LaSure, the administrator of the Centers for Medicare and Medicaid Services. 

What’s old is new again

The fight over Medicaid work requirements isn’t new. 

In 2018, the Trump administration issued optional guidance for states to craft work rules in the safety net program for the first time. Ultimately, 13 states adopted such rules under former president Donald Trump, though only Arkansas’s was in effect for a significant period of time. 

Once Biden took office, his Medicaid agency quietly began to send letters rescinding the work requirements, which had already faced a flurry of legal challenges and weren’t in effect.

Arkansas is planning to pursue the policy again, but with a twist. And a work requirement in Georgia is slated to begin this summer along with its partial expansion of Medicaid to roughly 64,000 people.

Read the full story from Tony and me here.

The Justice Department takes on the dueling abortion pill rulings

There was a lot of back and forth yesterday on the unprecedented, contradictory abortion pill rulings that sent abortion providers and legal experts scrambling on Friday.

White House press secretary Karine Jean-Pierre said it would be a “dangerous precedent” for the administration to ignore a Texas judge’s decision that would block the government’s decades-old approval of mifepristone.

• “But I’ll say this, you know, as a dangerous precedent is set for the court to set aside the FDA’s and expert judgment regarding a drug’s safety and efficiency, it will also set a dangerous precedent for this administration to disregard a binding decision,” Jean-Pierre said. “We are ready to fight this. This is going to be a long fight. We understand this. We stand by FDA approval of mifepristone.”

In a widely expected move, the Justice Department appealed the ruling, arguing that the challengers had no right to file the lawsuit since they were not personally harmed by the abortion pill, The Post’s Perry Stein, Ann E. Marimow and Caroline Kitchener report.

In its appeal, the Justice Department asked the right-leaning U.S. Court of Appeals for the 5th Circuit to put Judge Matthew J. Kacsmaryk’s order on hold until the legal challenge against it is decided. Without intervention, Kacsmaryk’s ruling is set to take effect this Friday.

• In a brief order posted late yesterday, the 5th Circuit ordered the groups challenging mifepristone’s approval to file their response by midnight today.
• The government and the drug’s manufacturer, Danco Laboratories, are urging the appeals court to issue its decision on pausing Kacsmaryk’s order by noon Thursday, “to enable the government to seek relief in the Supreme Court if necessary.” 

The Justice Department is also trying to sort out how it should handle a ruling in a separate abortion pill case that contradicts Kacsmaryk’s order. The government is asking a federal judge in Spokane, Wash., to clarify its obligations should Kacsmaryk’s suspension of the drug’s FDA approval be allowed to go into effect later this week.

That’s because Washington state Judge Thomas O. Rice last Friday ordered the FDA to preserve “the status quo” and retain access to mifepristone in the 17 states and D.C. that sued to keep the medication on their markets.

Meanwhile, the companies behind a key abortion drug are struggling to chart a path forward with the conflicting rulings — and one leading manufacturer is preparing for a rush in demand, The Post’s Aaron Gregg and Christopher Rowland report this morning.

Abby Long, a spokeswoman for Danco Laboratories, called on the FDA to clarify its approach. “We really do need the federal government to kind of step in,” she said “Our distributors will need that assurance to make sure they aren’t violating the law somehow by shipping this product.”

Sen. Catherine Cortez Masto (D-Nev.):

In other news in response to the ruling …

• In Massachusetts: Gov. Maura Healey (D) said yesterday that the state is stockpiling mifepristone, with 15,000 doses of the medication — enough to last more than a year in the state — expected to arrive this week.
• In California: Gov. Gavin Newsom (D) announced yesterday that he has secured an emergency stockpile of up to 2 million pills of misoprostol — the medication typically used alongside mifepristone in a two-step medication abortion regimen that can also be used to terminate a pregnancy on its own.
• More than 250 pharmaceutical executives signed an open letter yesterday criticizing Kacsmaryk’s ruling and calling for its reversal, saying the decision “ignores decades of scientific evidence and legal precedent.”

Massachusetts Attorney General Andrea Joy Campbell (D): 

White House launches $5 billion effort to speed new coronavirus vaccines

The Biden administration is launching a $5 billion-plus program to accelerate the development of next-generation coronavirus vaccines and treatments, our colleague Dan Diamond scooped.

The details: With “Project Next Gen” — the long-anticipated follow-up to the Trump-era “Operation Warp Speed” — the federal government will partner with private-sector companies to speed up their work on new vaccines and therapies. The initiative will focus on three goals, according to White House coronavirus czar Ashish Jha and others:

• Creating new, long-lasting monoclonal antibodies after many current treatments were rendered ineffective by the evolving virus.
• Accelerating the development of vaccines that stimulate mucosal immunity, which is thought to reduce transmission and infection risks.
• Speeding efforts to develop pan-coronavirus vaccines, which are intended to guard against new variants of SARS-CoV-2 as well as other coronaviruses.

Some of the lab work is already underway, and the government has begun efforts to find private-sector partners, officials said. But Jha declined to set a timeline for when the products might hit the market.

What we’re watching: The initiative is being funded with money originally intended for coronavirus testing and other priorities. That could tee up new questions from Republicans on Capitol Hill about why those funds were available, since Biden officials have spent months pressing Congress for additional pandemic aid, Dan notes.

Eric Topol, a professor of molecular medicine at Scripps Research: 

Lucky Tran, director of science communications at Columbia University: 

• President Biden signed a Republican-led resolution yesterday formally ending the coronavirus national emergency that former president Donald Trump enacted in March 2020, The Post’s Azi Paybarah reports.
• An African American man is seeking millions of dollars in damages and a better position on the kidney transplant waiting list in a lawsuit that claims an algorithm used in determining priority for organs is biased against Black people, our colleague Lenny Bernstein writes. 
• CMS released its annual Medicare payment rule for inpatient hospitals and long-term care facilities yesterday. If the proposal is finalized, acute-care hospitals would see a 2.8 percent pay increase in Medicare reimbursements, and long-term care hospitals would get a 2.9 percent bump.

Research with exotic viruses risks a deadly outbreak, scientists warn (By David Willman and Joby Warrick l The Washington Post)

Texas is home. The Briggle family and their trans child are fighting for it. (By Caitlin Gibson | The Washington Post)

Utah’s Secretive Medical Malpractice Panels Make It Even Harder to Sue Providers (By Jessica Miller | ProPublica and the Salt Lake Tribune )

Thanks for reading! See y’all tomorrow.