Medicaid is meant to serve as a backstop for the truly disadvantaged. It’s not supposed to be a replacement for a job. Physically able enrollees ought to work in exchange for their benefits.

A federal judge’s decision to bar Kentucky from imposing a work requirement on Medicaid recipients won’t discourage the Trump administration from considering similar requests from other states, CMS Administrator Seema Verma said Tuesday at the POLITICO Pro summit.

Voters in Idaho will get to decide in November whether the state will expand Medicaid, Secretary of State Lawerence Denney announced Tuesday. Denney certified that an activist group collected the required 56,192 signatures needed to place the measure on the ballot. Supporters of the measure say it would provide coverage for up to 62,000 Idahoans who now fall into a coverage gap, making too much to qualify for Medicaid but not enough to qualify for subsidized health insurance through the state insurance exchange. Idaho is one of 18 states that have yet to expand coverage under Obamacare using federal money. Idaho joins Utah as red states where Medicaid expansion will be put to a vote.

The legal dispute over Medicaid expansion came before the Maine Supreme Court Wednesday afternoon. Maine Equal Justice Partners and other consumer advocacy organizations are suing the state to force the LePage administration to implement the voter-approved law, and a lower court had ordered the state to file an expansion plan with the federal government. The administration appealed, arguing before the court that it can’t implement expansion or comply with the order without funding. Funding has been the central issue with Medicaid expansion politically in Maine, and it’s the central issue before the state Supreme Court. The court must decide whether a temporary stay on a lower court order should remain in place.

The Trump administration’s drive to wean poor people from government benefits by making them work has been slowed by a federal judge framing a fundamental question: Are poverty programs meant to show tough love or to help the needy?

U.S. District Judge James E. Boasberg in Washington last week halted Kentucky’s first-in-the-nation experiment with Medicaid work requirements, ruling that the Trump administration glossed over potential coverage losses. He sent the state’s plan back to federal authorities for a harder look.

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The federal Centers for Medicare and Medicaid Services has approved Oklahoma’s Medicaid program for a first-in-the-nation drug pricing experiment that supporters say could save taxpayer dollars and provide patients with the most effective medications for their ailments.

Under the “value-based purchasing” program approved in late June, the state and a pharmaceutical company would agree to a set payment if its medication works as advertised, but only a fraction of that if the drug is not as effective as promised.

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A provision of Obamacare that opponents once saw as a potential loophole allowing a Republican president to unravel the law by executive order is now being used by some states to steady their shaky Obamacare markets.

Since the inception of Obamacare, “state innovation waivers,” which ostensibly provide states with some flexibility to experiment with different ways to provide healthcare for their residents, were eyed by those seeking to repeal the law. During the 2012 Republican presidential primaries, Mitt Romney repeatedly vowed that if elected, “On Day One I would issue an executive order paving the way for Obamacare waivers to all 50 states.” Early in the Trump administration, officials saw the waivers as a backup plan to ease Obamacare regulations if congressional repeal efforts were unsuccessful.

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Sen. Lydia Brasch of Bancroft and former Sen. Mark Christensen of Imperial filed a lawsuit Tuesday attempting to block Nebraska’s proposed Medicaid expansion initiative from reaching the general election ballot.

The lawsuit was filed in Lancaster County District Court after Medicaid expansion supporters completed a petition drive that appears to have gathered sufficient signatures to win a slot on the November ballot.

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The decision by Judge James Boasberg immediately blocked Kentucky from enacting the provision in Campbell County, which had been set to start Sunday and roll out statewide later this year.

Within 36 hours, Kentucky Gov. Matt Bevin, a Republican, eliminated vision and dental benefits to nearly 500,000 Medicaid enrollees, saying the state could no longer afford it.

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One of the few major pieces of legislation moving this summer is the farm bill. Versions of the farm bill have passed both the House and the Senate, and a conference committee will begin the process of reconciling their differences shortly. Among the most striking and contentious differences are the House reforms to the Supplemental Nutrition Assistance Program (SNAP, or “food stamps”) that include work requirements. The Senate bill contains no work requirements.

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