X

Thank you for sharing!

Your article was successfully shared with the contacts you provided.
Click here for the full text of this decision FACTS:Congress enacted the Personal Responsibility and Work Opportunity Reconciliation Act in 1996. The Temporary Assistance to Needy Families part of the act replaced what was previously known as Aid to Families with Dependent Children. The purpose of the program is to increase state flexibility in operating welfare programs and to meet certain goals of ending dependence by promoting job preparation, work and marriage. As a condition of receiving grants under TANF, states must ensure that certain percentages of recipients participate in one of the 12 work activities enumerated in 42 U.S.C. 607. A individual is engaged in work if he or she is participating in one or more of these activities for at least 30 hours per week in certain proportions. The act further requires the state to submit a plan outlining its own proposal to require parents or caretakers to engage in work once the state determines that the parent or caretaker is ready to engage in work. The state’s plan must ensure that parents and caretakers receiving assistance engage in work activities in accordance with the 12 work activities. Meanwhile, Medicaid requires states to furnish medical assistance to eligible low-income individuals. The Medicaid Act allows states to terminate medical assistance in certain circumstances. For instance, states have the option of terminating a TANF recipient’s medical assistance for “refusing to work.” In 2003, Texas passed new PRWORA-related legislation. One part of the legislation, found in the Human Resources Code, addresses the state’s right to deny medical assistance for “refusing to work.’ Subsequently, the Texas Workforce Commission then promulgated rules of implementation. Texas Administrative Code 811.2(11) defines persons “engaged in work” for purposes of the TANF statute of work activities as those individuals who cooperate with “(A) all requirements set forth in the family employment plan, . . . ; and (B) all TANF Core and Non-Core activities.” The TANF core activities were further defined in the administrative code to include “job search and job readiness assistance,” and this phrase was defined, in turn, to include keeping up with activities related to recipients’ children’s health and dental checkups, the children’s immunizations, the children’s school attendance, their own use, possession or sale of controlled substances and their own abstinence from the use of alcohol. Thus, under the new rules, medical assistance can be terminated for those TANF recipients who failed to ensure their children’s immunizations, wellness check-ups, school attendance or who fail to avoid substance abuse. Two recipients of TANF benefits and Medicaid, as well as the Texas Welfare Reform Organization and the El Paso County Hospital District, sued the TWC, the Texas Health and Human Services Commission and the Texas Department of Human Services for relief from enforcement of the new rules. The district court granted the plaintiffs a declaratory judgment preventing DHS from terminating cash assistance under their new definitions. HOLDING:Affirmed. The court reiterates that a recipient’s medical assistance may be terminated for refusing to participate in the 12 work activities enumerated in 42 U.S.C. 607(d). None of these 12 activates, however, include child immunizations, wellness check-ups, school attendance or avoidance of substance abuse. The closest work activity is “job search and job readiness,” but this activity cannot be construed to encompass ensuring child immunizations, wellness check-ups, school attendance and refraining from substance abuse. The plain and natural meaning of 607 does not support the contention that a recipient’s assistance could be terminated for “refusing to work” when the recipient is working full-time. The court also finds that, in addition to this one provision, the rest of the statute is likely impermissible as well. The PRWORA further authorizes states to reduce TANF assistance for failure to comply with an imposed individual responsibility plan, which may include a requirement that individuals keep school-aged children current with the immunizations, and that they must attend parenting classes. The court rejects the state’s argument that these provisions, which allow reduction of benefits, complement state efforts to terminate medical assistance. Instead, the court agrees with the plaintiffs that these sections indicate that Congress wanted to give states flexibility to reduce TANF for people’s failures of responsibility. Had Congress wanted to give states the option of terminating medical assistance for those failures, it could have done so. “The district court judge properly concluded that . . . 811.2(A) and (B) are inconsistent with the federal Medicaid statute, as they impose additional requirements for obtaining benefits. Accordingly, the district court’s order declaring invalid 40 TEX. ADMIN. CODE 811.2(A) and (B), 811.41(d)(3)(A)-(D), to the extent they apply the job readiness activities in 811.41(d)(3) and the parenting skills training in 811.52(4), (5), (6), and (7) as grounds for terminating Medicaid by defining, or to the extent Defendants otherwise redefine by rule or through the personal responsibility agreement that recipients must sign, ‘work’ or ‘work requirements’ or ‘work activities’ or ‘job readiness’ to include obtaining children’s immunizations, check-ups, school attendance, or refraining from substance abuse, or any other non-work requirements for purposes of Medicaid eligibility is AFFIRMED.’ OPINION:Garza, J.; King, C.J., Garza and Benavides, JJ.

Want to continue reading?
Become a Free ALM Digital Reader.

Benefits of a Digital Membership:

  • Free access to 3 articles* every 30 days
  • Access to the entire ALM network of websites
  • Unlimited access to the ALM suite of newsletters
  • Build custom alerts on any search topic of your choosing
  • Search by a wide range of topics

*May exclude premium content
Already have an account?

 
 

ALM Legal Publication Newsletters

Sign Up Today and Never Miss Another Story.

As part of your digital membership, you can sign up for an unlimited number of a wide range of complimentary newsletters. Visit your My Account page to make your selections. Get the timely legal news and critical analysis you cannot afford to miss. Tailored just for you. In your inbox. Every day.

Copyright © 2020 ALM Media Properties, LLC. All Rights Reserved.