Arkansas to seek new work requirement for Medicaid expansion

LITTLE ROCK (AP) — Arkansas will ask the federal government to allow the state to require people on its expanded Medicaid program to work, Gov. Sarah Huckabee Sanders said Wednesday, trying to reinstate a requirement that was blocked by the courts and opposed by President Joe Biden's administration.

Unlike the previous requirement, Sanders said, the latest proposal won't cut off coverage to people who don't comply. Instead, it will move them from the private insurance used for Arkansas' expansion to the traditional fee-for-service Medicaid program.

"When able-bodied Arkansans don't work, volunteer or go to school, they aren't just a burden on the taxpayer," the Republican governor said at a news conference. "They're also being denied a chance to achieve independence from the welfare system. With today's change, we can break that vicious cycle."

About 300,000 people are on Arkansas' program, which was approved in 2013 as a compromise effort to enact a key part of the federal health overhaul in the heavily Republican state.

A federal judge in 2019 blocked a work requirement for the program advocated by Sanders' predecessor, former Gov. Asa Hutchinson. Biden's administration later rolled back work requirements in Arkansas and several other states. A federal judge last year cleared Georgia's plan to partially expand Medicaid with a work requirement.

Joan Alker, executive director of Georgetown University's Center for Children and Families, said the latest approach "adds a bizarre twist" to Arkansas' efforts to enact a work requirement with its threat to move them off private insurance plans and onto the traditional Medicaid program.

"Fundamentally, if the governor's goal is to strengthen Arkansas' workforce, this is a diversion and this is a waste of time and taxpayer dollars because this kind of approach is just not responsive to the challenges that people face in getting into the workforce," she said.

Will Watson, the state Democratic Party's director of strategy, criticized Sanders' proposal as a "mean-spirited tactic already rejected by a federal judge."

State Department of Human Services Secretary Kristi Putnam

said ARHome, the state's Medicaid expansion, offers additional support services that aren't available through the traditional Medicaid program.

Sanders declined to say whether she'd support keeping the state's expansion program if the work requirement plan is rejected.

Arkansas' Medicaid expansion has faced a funding fight nearly every year since it was created, because reauthorizing the program requires a three-fourths vote in the Legislature each year. The program has faced opposition from some Republicans who have called for ending the expanded coverage.

Legislative leaders the renewed push for a work requirement could help ward off another funding fight.

"I think it shows the governor is willing to use all of the tools available to us to make sure that able bodied individuals that are receiving this benefit are contributing in a meaningful way," Republican Sen. Missy Irvin, who chairs the Senate Public Health, Welfare and Labor Committee.

Putnam said the department expected to publish a draft of its proposal on April 23 for a 30-day comment period and submit it to the federal government on June 1. The state is proposing implementing the requirement in January.