Medicaid Expansion in Arkansas Continues Evolution, Adds Work Requirement

ACHI Health Policy Director Craig Wilson and President and CEO Dr. Joe Thompson provide a detailed look at the work requirement approved for Arkansas’s expanded Medicaid program in a blog post first published on Health Affairs.

Arkansas recently became the third state to receive approval from the U.S. Department of Health and Human Services (HHS) to implement a work requirement for Medicaid adults. The hand-delivered approval follows the department’s endorsement of work requirements submitted by Kentucky and Indiana and comes ahead of action on similar requests from a host of other states, including Arizona, Maine, New Hampshire, Utah, and Wisconsin. Arkansas’s request was among several proposed amendments to the state’s Section 1115 demonstration waiver for its Arkansas Works program, including a proposed income eligibility cap at 100 percent of the federal poverty level (FPL) for the expansion population, which HHS did not approve at this time.

The approval follows clear signals in early November from Seema Verma, Centers for Medicare and Medicaid Services (CMS) Administrator, that the administration would approve such requests. Following that, CMS issued a letter to Medicaid Directors formalizing their position. Arkansas’s waiver—which proposes to further the objectives of Medicaid by “promoting independence through employment”—had been under review by HHS since July 2017. Now, the state will begin notifying enrollees that continued health care coverage is contingent upon meeting or being exempt from a work requirement, unless implementation is halted through litigation. Notices are expected to be sent to enrollees in early April, with reporting requirements to begin in June.

Continue reading on Health Affairs.