Here’s another report on Arkansas’s flawed rule requiring work efforts by Medicaid recipients. More criticism.

The Center on Budget and Policy Priorities reviews the January report on compliance with the rule, a month in which the age group required to report work efforts expanded.


In Arkansas, beneficiaries lose coverage if they don’t comply for three months in a year. The three-month “clock” reset in January, so no beneficiaries lost coverage for not reporting in January. But the state’s January data show continued high rates of non-compliance among those required to report. The state exempted almost 90 percent of the 105,000 beneficiaries subject to the work requirement, leaving just under 12,000 who had to report. Of those required to report work activities, about 87 percent failed to report or failed to report enough hours to meet the requirement. Almost 9,000 beneficiaries now have one month of non-compliance in 2019 and, with two more this year, will lose coverage.

The low reporting numbers in January suggest that 19- to 29-year-olds are struggling with the same issues the older group has faced: lack of awareness that they are subject to a work requirement, difficulty reporting their compliance, and trouble understanding the complex rules around exemptions and allowable work activities.

Moreover, the state keeps expanding the population subject to the work requirement despite lacking an approved research and evaluation plan. If the waiver doesn’t give beneficiaries incentives to participate or improve health outcomes, the Centers for Medicare and Medicaid Services (CMS) can end it. But CMS hasn’t even begun to evaluate the waiver’s effectiveness, though Arkansas’ work requirement has been in place for over eight months and has taken coverage away from thousands.

This was the plan, of course. The article holds up Arkansas as an example for other states on what doesn’t work. The federal government, meanwhile, is trying to get a lawsuit against the rule dismissed. No wonder. It’s a winner. Medicaid was designed to help people get medical coverage, not deprive them.