Kentucky legislators were excited about being the first to launch the new Medicaid waiver for work requirements, but some state residents on the health care plan had a different view.

Fifteen Kentuckians enrolled in Medicaid filed a class action lawsuit on Jan. 24 against the Trump administration challenging its approval of changes to Medicaid law that will “endanger the health care of tens of thousands of low-income individuals and families in the state.” The residents are represented by the National Health Law Program (NHeLP), Kentucky Equal Justice Center and the Southern Poverty Law Center.

The lawsuit was filed in the U.S. District Court for the District of Columbia and charges that Kentucky’s recently approved Medicaid waivers violate the HHS secretary’s authority under the Social Security Act, “because they are not an experimental project that is consistent with the objectives of the Medicaid Act,” according to a NHeLP press release. The program said it is the first lawsuit brought to challenge a Trump administration Medicaid waiver approval.

“Through imposition of premiums and cost sharing, ‘lockouts,’ benefits cuts and a work requirement, the waiver will radically reshape Medicaid in a manner that, by the state’s own admission, will result in substantial reductions in coverage,” the lawsuit states.

NHeLP legal director Jane Perkins said HHS far exceeded the agency’s authority in granting Kentucky’s waiver.

“These waiver approvals raise a host of legal issues — not just the work requirements and premiums but eliminating health care services, such as transportation to health care facilities or providers. This amounts to a project demonstrating how to destroy a strong health care program,” Perkins said in a NHeLP press release. “Allowing the state to ignore fundamental Medicaid protections will result in large numbers of low-income individuals and families losing health care coverage. We are calling on the federal court to step in and stop the Trump administration from re-writing the Medicaid Act and stripping Kentuckians of vital health care.”

In the Jan. 11 memo, CMS administrator Seema Verma said individuals with disabilities or those considered “medically frail” are exempt under any work requirement rules imposed by states. This would include patients with chronic kidney disease or end-stage renal disease who are on Medicaid. Other states that have submitted waiver requests to CMS include Arkansas, Wisconsin, Utah, Mississippi, Kansas, Arizona, Maine and New Hampshire. The Trump administration approved Indiana’s request for the waiver on Feb. 3.