Arkansas Becomes Third State with Medicaid Work Requirement

Questions still linger regarding specifics of implementation.

By Mark Spivey

Arkansas has become the nation’s third state to implement a work requirement for Medicaid, according to an announcement made earlier this week by Governor Asa Hutchinson and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma.

The state expects to notify applicable Medicaid recipients during the first week of April and require a select group to report on their work, education, and training activities by the start of June, according to a report published in Healthcare Dive.

The report noted that Arkansas has not yet won approval for a part of the proposal that would change the income requirement for Medicaid to 100 percent of the federal poverty level (instead of 138 percent).

“The Arkansas Department of Human Services estimated the work requirement and its planned income requirement would save the state $356 million in the next fiscal year. Most of that amount ($307 million) would come from the income requirement change,” Healthcare Dive’s report read. “Implementing both waivers would also result in nearly 63,000 people losing Medicaid coverage out of the more than 285,000 who currently get insurance through Medicaid in the state.”

Kentucky and Indiana are the two other Republican-led states that have introduced plans for a Medicaid work requirement, although Arkansas reportedly wants to be the first to actually implement one. In making the announcement, Verma reportedly said there are also eight other states with Medicaid work requirement waiver requests, with still others that have shown interest.

“In announcing the Arkansas work requirement waiver at the State House in Little Rock on Monday, Hutchinson said the state and CMS decided to move forward with launching the work requirement and not wait until they iron out the income eligibility piece,” Healthcare Dive’s report read. “The governor said the work requirement isn’t about ‘punishing anyone,’ but instead giving ‘people an opportunity to work.’ Hutchinson said the work requirement includes training and education programs to help people get out of poverty and jobs.”  

Verma reportedly described CMS as a “willing partner” with states showing similar proclivities.

The work requirement ultimately is said to be poised to affect Arkansas Works enrollees (those who receive coverage through Medicaid expansion) between 19 and 49 years old, with the Natural State easing in the requirement for 30-to-49-year-olds between June and September. Recipients will need to report 80 hours of work every month, to include job training, job searching, school, health education classes, or volunteering; those who don’t meet the requirement for any three months in a calendar year will reportedly lose coverage.

The plan has been met with fierce opposition in a nation with wealth inequality that has worsened dramatically during recent decades while working-class wages have stagnated.

“Critics say work requirements will only serve to make access to care more difficult for those who need it most. The majority of Medicaid beneficiaries are already from working families, but the requirement’s bureaucratic hurdles and paperwork needs could leave out those who should qualify,” Healthcare Dive noted.

“The harsh work requirement in Medicaid will likely set back the state’s considerable progress under the (Patient Protection) and Affordable Care Act (PPACA) in increasing coverage and improving access to care, health, and financial stability for low-income Arkansans,” Center on Budget and Policy Priorities Vice President Judith Solomon noted in a blog post.

Last year, Arkansas implemented a “work referral” process for Arkansas Works and has tracked how people referred to job searches and training have been progressing.

“The results of the referral showed that individuals who take advantage of these services are more likely to find a job than those who do not. Shifting from a voluntary ‘referral’ to a mandatory requirement that individuals work in order to receive their health insurance is expected to increase the number of enrollees who take advantage of state programs to assist in developing skills and obtaining jobs,” Hutchinson’s office said in a press release.

Facebook
Twitter
LinkedIn

Mark Spivey

Mark Spivey is a national correspondent for RACmonitor.com, ICD10monitor.com, and Auditor Monitor who has been writing and editing material about the federal oversight of American healthcare for more than a decade.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

The Cost of Ignoring Risk Adjustment: How HCCs Impact Revenue & Compliance

The Cost of Ignoring Risk Adjustment: How HCCs Impact Revenue & Compliance

Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals.  Don’t miss this chance to protect your hospital’s revenue and reputation!

May 29, 2025
I050825

Mastering ICD-10-CM Coding for Diabetes and it’s Complications: Avoiding Denials & Ensuring Compliance

Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!

May 8, 2025
2025 Coding Clinic Webcast Series

2025 ICD-10-CM/PCS Coding Clinic Update Webcast Series

Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 14, 2025

Trending News

Featured Webcasts

The Two-Midnight Rule: New Challenges, Proven Strategies

The Two-Midnight Rule: New Challenges, Proven Strategies

RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.

June 19, 2025
Open Door Forum Webcast Series

Open Door Forum Webcast Series

Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.

June 11, 2025
Open Door Forum: The Changing Face of Addiction: Coding, Compliance & Care

Open Door Forum: The Changing Face of Addiction: Coding, Compliance & Care

Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025.  Register today and be a part of the conversation!

July 16, 2025

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

This Memorial Day, we honor those who gave all for our freedom. Take 20% off sitewide through May 31 with code MEMORIAL25 at checkout

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24