Rose v. Kennedy

Issue: Were the HHS Secretary’s decisions to allow Indiana to continue to restrict Medicaid eligibility and coverage in its Section 1115 demonstration waiver arbitrary and capricious? 

Background: Medicaid enrollees sued to challenge the eligibility and coverage restrictions in Indiana’s Section 1115 demonstration waiver. Specifically, they challenged HHS’s 2020 decision to renew the demonstration, allowing Indiana to continue to impose premiums and eliminate retroactive coverage and non-emergency medical transportation, and HHS’s 2023 decision to allow premiums to continue. The district court vacated the approvals, finding that the Secretary failed to consider the demonstration’s impact on Medicaid’s primary purpose of providing health coverage to low-income people. 

Current Status: Appeal pending in D.C. Circuit Court of Appeals

D.C. Circuit Court of Appeals Amicus Brief, July 2, 2025

Amici: American Public Health Association and 67 public health deans and scholars.

Argument Summary: Congress enacted Section 1115 to permit states to test new approaches to expand access, provide better services, and strengthen social programs. HHS’s renewals of the eligibility and coverage restrictions in Indiana’s demonstration violated research norms by failing to ensure a methodologically sound evaluation; lacked an evidentiary basis; and ignored proven harm to enrollees. 

Outside Counsel:  Feldesman LLP

Related Resources: 

GW Media Relations. Public Health Leaders Urge Court to Protect Medicaid Beneficiaries from Harmful Waivers in Indiana. July 9, 2025. https://mediarelations.gwu.edu/public-health-leaders-urge-court-protect-medicaid-beneficiaries-harmful-waivers-indiana 

Funding Acknowledgement: Supported by the Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund, its directors, officers, or staff.