Whether the Secretary may authorize demonstration projects to test requirements designed to promote the provision of health-care coverage by facilitating the transition of Medicaid beneficiaries to commercial coverage and improving their health

QUESTION PRESENTED The Social Security Act, 42 U.S.C. 301 et seq., authorizes the Secretary of Health and Human Services to approve “any experimental, pilot, or demonstration project” proposed by a State that, “in the judgment of the Secretary, is likely to assist in promoting the objectives” of the Medicaid program. 42 U.S.C. 1815(a). Exercising that authority, the Secretary approved demonstration projects in Arkansas and New Hampshire designed to test whether certain requirements promote those objectives by requiring certain working-age, nondisabled adults to engage in work or skill-building activities (such as job-skills training or general education) as a condition of continued eligibility for Medicaid benefits. The Secretary determined that such requirements may help beneficiaries transition to employersponsored or federally subsidized commercial coverage and may lead to improved beneficiary health, which in turn may help States conserve resources that can be redirected to providing other coverage. The court of appeals held the Secretary’s approvals unlawful. It concluded that “the principal objective of Medicaid is providing health care coverage,” and that the Secretary had failed adequately to consider whether the projects would further that objective. App., infra, 9a-10a; see id. at 12a-21a. The question presented is as follows: Whether the court of appeals erred in concluding that the Secretary may not authorize demonstration projects to test requirements that are designed to promote the provision of health-care coverage by means of facilitating the transition of Medicaid beneficiaries to commercial coverage and improving their health. (I)