For Immediate Release: July 9, 2025
Media contact: Katelyn Deckelbaum, katelyn [dot] deckelbaum
gwu [dot] edu (katelyn[dot]deckelbaum[at]gwu[dot]edu)
WASHINGTON (July 9, 2025) – The American Public Health Association, along with 67 leading deans and scholars in public health and health law, has filed an amicus brief in the U.S. Court of Appeals for the D.C. Circuit in Monte Rose Jr., et al. v. Robert F. Kennedy, Jr., et al. The brief urges the court to affirm a lower court ruling that the federal government violated the law by allowing Indiana to continue to restrict Medicaid eligibility and coverage of services in its Section 1115 demonstration waiver .
The amici argue that the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) violated federal law and research standards when they renewed Indiana’s demonstration in 2020 and 2023. These decisions allow the state to continue imposing premiums and eliminate retroactive coverage and non-emergency medical transportation services. These restrictions result in the loss of healthcare access for low-income enrollees, according to extensive research.
“These waivers were never meant to be used as a way of taking away Medicaid services from people and their families,” said Lynn Goldman, the Michael and Lori Milken Dean of the GW Milken Institute School of Public Health and one of the amici. “Indiana’s waiver has resulted in real harm—tens of thousands of people have lost coverage or gone without essential care.”
Key Points from the Amicus Brief:
- Disregard of Harm to Enrollees: A large body of research demonstrates that premiums cause low-income people to lose coverage and reduce access to necessary health care. Those who couldn’t afford the premiums lost their benefits, went without insurance and had worse health outcomes. Taking away retroactive coverage and transportation left low-income people at risk for medical debt and made it harder to get basic care.
- Violation of Congressional Intent: The amici emphasize that Congress intended Section 1115 demonstrations to strengthen social programs and provide better services to low-income populations, not reduce coverage or shift blame to enrollees for structural barriers to care.
- Lack of Sound Evidence and Evaluation: Federal officials approved the waivers without making sure they were properly evaluated. Indiana’s demonstration evaluation violates basic research norms and CMS’s own best research practices.
“The 1115 waiver process was designed to allow for innovation at the state level to improve the health and wellbeing of beneficiaries of the Medicaid program,” said Georges C. Benjamin.
“Indiana is using this process to undermine the health of its citizens by limiting access to important services. Medicaid is a life-saving insurance plan and a vital component of our health safety net for all Americans.”
The brief reinforces that policy decisions impacting the health of millions must be based on rigorous research, transparent evaluation and a clear commitment to Medicaid’s core purpose: providing – not taking away – health care to those who cannot afford it.
The court’s decision in this case could have sweeping implications for the future of Medicaid demonstrations and the scope of the federal government’s authority when considering state proposals that restrict eligibility and benefits.
The brief can be accessed here.
The amici are represented by Feldesman LLP in Washington, D.C.
The views presented in the brief represent those of the amici and do not necessarily reflect the views of their institutions.