On Thursday, Arkansas Governor Sarah Huckabee Sanders announced her intention to impose work requirements on some Medicaid recipients, aiming to revive and expand a restriction that had previously been blocked by the courts but could potentially be reinstated under the Trump administration.
Sanders’ comments come as other Republican governors across the country are pushing for similar requirements along with various cuts or restrictions to Medicaid, which serves approximately 80 million people nationwide.
Under Sanders’ predecessor, Asa Hutchinson, Arkansas implemented work requirements in 2018 that led to more than 18,000 people losing coverage. The requirement, which applied only to able-bodied adults enrolled in the state’s expansion program, was blocked by federal courts and the Biden administration.
“I have more confidence because it’s a new administration that I think will be more supportive of things like work requirements,” Sanders said in a statement to reporters. “They’ve already publicly stated that, and I think a greater willingness to work with states to make changes.”
Sanders is part of a growing group of Republican governors planning similar work requirements for Medicaid recipients. Iowa Governor Kim Reynolds recently announced her intention to pursue a similar mandate for able-bodied Medicaid recipients, while South Carolina Governor Henry McMaster has asked the state’s health agency to request the reinstatement of its work requirement once Trump assumes office.
The potential new round of work requirements is likely to trigger fresh litigation, reigniting legal challenges to the restriction. Advocacy groups have expressed concerns, especially as Republicans in Congress push for broader Medicaid cuts.
Republicans have long advocated for work requirements for the program. A provision passed by the House in 2023 could have led to more than half a million of the poorest Americans losing health insurance.
Joan Alker, executive director of the Georgetown Center for Children and Families, criticized work requirements, arguing they create additional barriers for low-income adults. “When people are able to address their health conditions, they’re more likely to be able to work,” Alker said. “I think the policy gets it backwards while supporting a goal that most Americans support.”
Currently, Georgia is the only state with a work requirement for some Medicaid recipients. Governor Brian Kemp has expressed a desire to allow parents and guardians of children under age 6, in households at or below 100% of the federal poverty level, to enroll in Medicaid without meeting the work requirement.
Other states are also considering cuts to Medicaid. In Idaho, some GOP lawmakers are advocating for the repeal of the state’s Medicaid expansion.
Meanwhile, Kansas’ Democratic Governor Laura Kelly is pushing in the opposite direction, urging the GOP-dominated Legislature to expand Medicaid. However, Republican leaders are expected to block the move.
Sanders, for her part, said she wants to maintain Arkansas’ Medicaid expansion in some form. Arkansas was one of the few Southern states to expand Medicaid under the Affordable Care Act, and more than 200,000 people currently benefit from the program.
“I don’t think we’re in a place where you can at this point do away with the expansion,” Sanders said. “We’re too far down the road.”
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