A 3-judge panel on the U.S. Court of Appeals for the District of Columbia struck down Arkansas work requirements for Medicaid. In a unanimous opinion, the court laid down a simple principle: Medicaid was established to provide medical assistance to people who can't afford it.

Judge David B. Sentelle, a Reagan appointee known to be quite conservative, wrote the opinion upholding a lower court's decision.

"The district court is indisputably correct that the principal objective of Medicaid is providing health care coverage," he wrote, destroying the idea that health care is something which must be earned.

Putting an exclamation point on that, he adds this, later in the opinion: "In sum, “the intent of Congress is clear” that Medicaid’s objective is to provide health care coverage, and, as a result, the Secretary “must give effect to [that] unambiguously expressed intent of Congress.”

Azar and his minion Seema Verna tried to cloak the Medicaid work requirements in a mask of "positive health outcomes," as if work requirements were somehow analogous to weight loss programs or smoking cessation. Judge Sentelle was not having it. Using TANF and SNAP as examples of programs created with the express purpose to lend a helping hand until people could get on their feet and work, Sentelle pointedly noted, "In contrast, Congress has not conditioned the receipt of Medicaid benefits on fulfilling work requirements or taking steps to end receipt of governmental benefits."

As Joan McCarter notes, this case will head to the Supreme Court, but it's an uphill battle, given that even conservative judges have some respect for the actual text of a law. Meanwhile, work requirement requests have been approved but not yet implemented in Arizona, Ohio, South Carolina, Utah, and Wisconsin.

For now, they will not be able to implement them. What the Supreme Court will do is anyone's guess, but at least the conservative dream of letting the poor and elderly die and die quickly is on ice for now.