Federal-State Health Waiver Talks Are Less Indulgent, More Open

The Biden administration’s swift and public actions to undo state work requirements for Medicaid breaks from the generally indulgent past approach to pilot health programs, signaling a forthcoming transformation in the waiver system.

The Department of Health and Human Services’ recent notices to several states that it’s rolling back Trump-era must-work rules for adults on Medicaid is straight out of the administrative-law playbook, involving public notice and an opportunity for hearings before an HHS review board. That sets up the agency’s likely defense against further litigation down the road.

The new strategy contrasts with a history of federal-state wrangling over ...