News! The Biden administration has informed states *both* that it's withdrawing Medicaid work requirement waivers and* that it won't follow a letter from the outgoing administration saying that no waivers could be withdrawn for at least nine months. https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/in-cms-ltr-state-02122021.pdf

This is a big deal, and not only because the Biden administration is ending work requirements. We knew that was coming. It's a big deal because the Biden administration is signaling that it's going to move quickly to withdraw the waivers -- sooner than nine months.

Why? Because the Supreme Court is poised to hear a case about the legality of Medicaid work requirements. Lower courts have said they're not. But if the Supreme Court says they're legal, the next Republican administration could quickly reimpose them.

So the stakes aren't about what happens next year. It's about what happens in 2025 or 2029.

What's the justification for ignoring the Trump administration letter saying that waivers couldn't be withdrawn for at least nine months? We don't have a full legal rationale yet, but CMS emphasizes in today's letter the need to maintain flexibility.

If the validity of the letter gets litigated (e.g., if a state whose waiver is withdrawn challenges that waiver), I bet the Biden administration will say that an unceremonious, precipitate change to program terms can be unceremoniously withdrawn.

This isn't (the Biden team would say) the kind of intergovernmental agreement that the courts will enforce under Pennhurst. The 9-month delay wasn't part of the original waiver package, and the states gave no consideration in exchange for the 9-month limitation.

It's just a guidance document, the kind that can be adopted and withdrawn without formal ceremony.

Will that argument work? I think there's a lot to it, but it's hard to know how it'll strike a federal judge. So there's some uncertainty here.

The key for now is to see that the Biden administration isn't screwing around. It's planning on moving quickly to withdraw these waivers and moot the pending Supreme Court case, some legal risk be damned.

And I say: all the more power to 'em. /fin