the Arkansas Department of Health and Human Services recently announced it would be working with the Trump Administration for a waiver to implement Medicaid work requirements. As Little Rock Public Radio reports, during an interview on Arkansas PBS, Arkansas Deputy Health Secretary Janet Mann said the health department wants to make sure there are no communication problems with such a policy. “In this waiver amendment we are going to exercise lots of technology for matching of community activities and work options and then try to work with the beneficiaries and not have them have a monthly reporting option which was reported back to us, as heavily burdensome.”
In June 2018, Arkansas became the first state in the country to require some Medicaid recipients to work, volunteer, go to school or participate in job training to receive benefits. By April 2019, a federal judge struck down the change, but not before more than 18,000 Medicaid recipients lost coverage. The following year, in February 2020, a federal appeals court upheld this decision. This time around, Mann says the work requirement policy would impose a suspension of Medicaid coverage, not termination, with the intended goal of passing judicial scrutiny.
On January 28, 2025, Arkansas Governor Sarah Huckabee Sanders held a news conference in which she announced having sent a letter to Health and Human Services (HHS) Secretary-Designate, Robert F. Kennedy Jr., regarding a Medicaid work requirement plan. Gov. Sanders stated their policy goal as, “to have Medicaid serve as a safety net rather than a poverty trap.”
The letter also stated, “there are 220,000 able-bodied, working-age adults in Arkansas receiving free healthcare courtesy of the taxpayer, costing us more than $2.2 billion each year – and growing.” The letter further explained that estimates show nearly 90,000 have no job, describing the current situation as “a backward, broken system.”
Yet analysis by the Congressional Budget Office of a work requirement proposal concluded the change “would lead to lower federal costs, an increase in the number of uninsured people, no change in employment or hours worked by Medicaid recipients, and a rise in state costs.”
A separate analysis by the health policy research, polling, and news nonprofit agency KFF found that “92% of Medicaid adults were working full- or part-time, or were not working due to caregiving responsibilities, illness or disability, or school attendance – reasons that counted as qualifying exemptions from the work.” The KFF brief concluded that adding work requirements to Medicaid imposes an administrative burden that may offset any savings.
Despite such findings, more states are expected to once against pursue Medicaid work requirements. A new report by the Center on Budget and Policy Priorities (CBPP) stated that recent proposals from Republican congressional leaders and conservative think tanks could put an estimated 36 million Medicaid enrollees - including people in every state – at risk of losing their health coverage.
