LITTLE ROCK, Ark. — Governor Sarah Huckabee Sanders of Arkansas expressed her desire to implement work requirements for certain Medicaid recipients, aiming to reintroduce restrictions that were previously overturned by the courts but might find new support due to a change in federal administration. This initiative aligns with efforts by Republican leaders in various states who are advocating for similar regulations, seeking to modify or restrict Medicaid, a program that currently assists approximately 80 million individuals nationwide.
The previous attempt to enforce work requirements in Arkansas, initiated under former Governor Asa Hutchinson in 2018, resulted in over 18,000 individuals losing their coverage. This stipulation was directed solely at able-bodied adults within the state’s Medicaid expansion program but faced legal challenges that halted its implementation under both federal courts and the Biden administration.
Sanders is pushing for a more comprehensive work requirement that would encompass able-bodied adults enrolled in both traditional and expansion Medicaid programs. She expressed optimism about the possibility of these changes being accepted at the federal level, suggesting that the current administration may be more amenable to such requirements. “I have more confidence because it’s a new administration that I think will be more supportive of things like work requirements,” she stated to reporters, underscoring the belief that the new federal government would be more open to collaborating with states on these modifications.
This move is part of a larger trend among Republican governors seeking to establish similar work requirements within their states. Iowa Governor Kim Reynolds announced intentions to pursue a comparable mandate for able-bodied Medicaid participants, while South Carolina Governor Henry McMaster has directed the state health agency to petition for reinstating work requirements once Trump assumes office again.
The reintroduction of work requirements is expected to lead to renewed legal battles over such policies. Advocacy groups have raised alarms about the potential for broader Medicaid cuts as Republicans in Congress continue to promote work requirements. A provision passed in the House in 2023, aimed at reducing eligibility, would have left over 500,000 low-income Americans without health coverage.
Joan Alker, director of the Georgetown Center for Children and Families, criticized work requirements as ineffective, arguing that they create unnecessary barriers for low-income individuals. “When people are able to address their health conditions, they’re more likely to be able to work,” she noted, suggesting that such policies misinterpret the challenges facing these communities while attempting to achieve a generally shared goal.
Currently, Georgia stands as the only state with a work requirement for some Medicaid recipients. Governor Brian Kemp has indicated plans to allow parents and guardians of children aged 6 or younger in households earning at or below 100% of the federal poverty level to enroll in Medicaid without these stipulations.
Additionally, some Republican lawmakers in Idaho are advocating for the repeal of the state’s Medicaid expansion, demonstrating a trend towards cuts in multiple states. In contrast, Kansas’ Democratic Governor Laura Kelly has urged the GOP-controlled legislature to expand Medicaid; however, Republican leadership is expected to impede such efforts.
Meanwhile, Sanders reiterated her commitment to retaining Arkansas’ Medicaid expansion in some capacity, acknowledging the significant number of over 200,000 individuals who rely on the program. “I don’t think we’re in a place where you can at this point do away with the expansion,” she asserted, emphasizing that Arkansas has progressed too far to abandon the initiative.
