The Washington Post - 31.07.2019

WEDNESDAY, JULY 31 , 2019. THE WASHINGTON POST EZ RE A

BY AMY GOLDSTEIN

A federal judge has expanded

the legal obstacles to the Trump

administration’s efforts to compel

certain poor people to get jobs in

exchange for Medicaid, ruling

that New Hampshire cannot

move ahead with such new re-

quirements.

The ruling Monday marks the

third state for which U.S. District

Judge James E. Boasberg has held

that federal health officials were

“arbitrary and capricious” when

they approved the state plans,

failing to consider the require-

ments’ effects on low-income resi-

dents who rely on Medicaid for

health coverage.

Boasberg, of the U.S. District

Court for the District of Colum-

bia, blocked New Hampshire’s

plan four months after he ruled

that Arkansas needed to stop the

work requirements it had begun

the previous June. At the same

time, the judge struck down simi-

lar requirements in Kentucky for

a second time.

“In short, we have all seen this

movie before,” Boasberg wrote in

his 35-page New Hampshire rul-

ing.

His opinion said that the rules

New Hampshire has been prepar-

ing to put into effect are “more

exacting” than in the other two

states, applying to a wider age

range of low-income residents

and calling for 100 hours a month

— 20 hours more — of work,

school, job training or volunteer-

ing to meet the requirement.

New Hampshire had been in-

tending to start its requirements

this month. But Gov. Chris Su-

nunu (R) announced three weeks

ago that the state would postpone

them until September, after near-

ly 17,000 of about 25,000 Medic-

aid recipients who do not have an

exemption from the rules did not

provide required evidence in June

that they met the requirements.

The state is now undertaking a

door-to-door campaign to try to

increase awareness of the re-

quirements.

Sununu issued a statement

calling Boasberg’s decision “dis-

appointing but not surprising giv-

en this judge’s past rulings.”

The governor called the work

rules “a key provision” of New

Hampshire’s law that expanded

its Medicaid program under the

Affordable Care Act. He said the

state was putting in the require-

ments “responsibly and in a man-

ner that would ensure that no

individual would inappropriately

lose coverage.” As for whether the

state will appeal, the governor

said, “a ruling from one federal

trial court judge in Washington

D.C. is only the first step in the

process” and predicted New

Hampshire’s rule eventually will

be upheld.

In Arkansas, about 18,000 resi-

dents lost their insurance before

the judge ruled that federal health

officials had not adequately con-

sidered the rule’s effects.

The requirements and the

court challenges are part of an

ideological seesaw about the

Great Society-era program that is

the nation’s largest form of safety-

net health insurance. For the first

time in Medicaid’s half-century,

the Trump administration an-

nounced in early 2018 that it

would allow states to impose

work requirements as a condition

of getting Medicaid benefits.

So far, the administration has

approved work requirements in

eight states, with several more

pending. One of those states, Indi-

ana, began phasing in its require-

ments earlier this year, but no one

is yet being penalized.

After Boasberg’s latest ruling

Monday, Johnathan Monroe, a

spokesman for the Department of

Health and Human Services’ Cen-

ters for Medicare and Medicaid

Services, said in a statement: “As

we have said before, we will con-

tinue to defend our efforts to give

states greater flexibility to help

low-income Americans rise out of

poverty.”

In April, the Trump adminis-

tration appealed the judge’s Ken-

tucky and Arkansas rulings. Mon-

roe could not say whether the

New Hampshire ruling will be-

come part of the appeal.

[email protected]

Judge blocks N.H. plan

BY MARIA SACCHETTI for Medicaid work rules

Lawyers for the American Civil
Liberties Union told a federal
judge Tuesday that the Trump ad-
ministration has taken nearly
1,000 migrant children from their
parents at the U.S.-Mexico border
since the judge ordered the United
States government to curtail the
practice more than a year ago.
In a lengthy court filing in U.S.
District Court in San Diego, law-
yers wrote that one migrant lost
his daughter because a U.S. Border
Patrol agent claimed that he had
failed to change the girl’s diaper.
Another migrant lost his child be-
cause of a conviction on a charge
of malicious destruction of prop-
erty with alleged damage of $5.
One father, who lawyers say has a
speech impediment, was separat-
ed from his 4-year-old son because
he could not clearly answer Cus-
toms and Border Protection
agents’ questions.
Acting Homeland Security sec-
retary Kevin McAleenan has said
that family separations remain
“extraordinarily rare” and happen
only when the adults pose a risk to
the child because of their criminal
record, a communicable disease,
abuse or neglect. Of tens of thou-
sands of children taken into cus-
tody at the border, 911 children
were separated since the June 26,
2018, court order according to the
ACLU, which cited statistics as of
June 29 that the organization re-
ceived from the government as
part of ongoing legal proceedings.
While the judge recognized that
parents and children might still be
separated when a parent is found
to pose a risk to their child, the
ACLU and others say federal im-
migration and border agents are
splitting up families for minor al-
leged offenses — including traffic
violations — and urged the judge
Tuesday to clarify when such sepa-
rations should be allowed.
Approximately 20 percent of
the new separations affected chil-
dren under 5 years old, the ACLU
said, compared with about 4 per-
cent last year.
“They’re taking what was sup-
posed to be a narrow exception for
cases where the parent was genu-
inely a danger to the child and
using it as a loophole to continue
family separation,” ACLU lawyer
Lee Gelernt said in an interview.
“What everyone understands in-
tuitively and what the medical evi-

dence shows, this will have a dev-

astating effect on the children and

possibly cause permanent dam-

age to these children, not to men-

tion the toll on the parents.”

The Justice Department and

the Department of Homeland Se-

curity declined to comment Tues-

day.

The tally of child separations

adds to the approximately 2,

children who were taken from

their parents during a chaotic, six-

week period from May to June 20

last year, when a Trump adminis-

tration border crackdown trig-

gered one of the worst crises of his

presidency.

The policy sought to deter a

crush of asylum seekers, who were

surrendering as families at the

U.S. southern border, by prosecu-

ting parents for the crime of illegal

entry and sending their children

to federal shelters. Reports of

traumatized, crying children led

to widespread demands to reunite

the families.

Trump ordered federal officials

to stop separating families on

June 20, 2018, and said it is the

“policy of this Administration to

maintain family unity” unless the

parent poses “a risk” to the child.

Six days later in San Diego, U.S.

District Judge Dana M. Sabraw, an

appointee of President George W.

Bush, ordered the Trump adminis-

tration to reunite the families, a

process that dragged on for

months because the government

had failed to track the parents and

children after splitting them up. A

still-unknown number of families

were separated before the policy

officially began.

McAleenan, who at the time

signed off on the zero tolerance

policy and carried it out as com-

missioner of U.S. Customs and

Border Protection, told the Senate

Homeland Security and Govern-

mental Affairs Committee in May

that family separations are “ex-

traordinarily rare” and make up a

tiny portion of the now more than

400,000 families taken into cus-

tody at the border since the court

ruling.

At that time, he testified, about

one to three family separations

happened out of about 1,500 to

3,000 family members appre-

hended each day. He also said then

that separations occur “under

very controlled circumstances.”

Testifying before the U.S. House

Oversight and Reform Committee

on July 18, McAleenan empha-

sized that the separation process

is “carefully governed by policy

and by court order” to protect the

children.

“This is in the interest of the

child,” he said. “It’s overseen by a

supervisor, and those decisions

are made.”

Of the 911 child separations, 678

were for alleged criminal history,

the ACLU said Tuesday, citing gov-

ernment records. Offenses includ-

ed drunken driving, assault and

gang affiliation, as well as theft,

disorderly conduct and minor

property damage.

Many cases lacked details about

the alleged crimes, the ACLU said,

and several charges were decades

old. Among those separated be-

cause of concerns about parental

fitness were an HIV-positive fa-

ther of three young daughters and

a mother who broke her leg and

required surgery.

Child advocates and medical

professionals have repeatedly

warned that separating children

from their parents can lead to

lasting severe physical and emo-

tional disorders.

“Forcibly separating children

from their parents is like setting a

house on fire,” Jack Shonkoff, a

pediatrics professor at Harvard

Medical School, said in an affida-

vit included in the ACLU’s motion.

“Prolonging that separation is like

preventing the first responders

from doing their job and letting

the fire continue to burn.”

[email protected]

ACLU: Nearly 1,000 children separated since ban

CAROLYN VAN HOUTEN/THE WASHINGTON POST

A migrant family walks toward an area near the Anzalduas International Bridge in McAllen, Tex.,

where U.S. Border Patrol agents were to begin processing them after they arrived from Mexico.

Action further frustrates

Trump administration’s

jobs-for-insurance effort

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