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Work Requirement Approved for Medicaid Enrollees

Gov. Asa Hutchinson announces the approval of work requirements alongside Department of Workforce Services Director Daryl Bassett, left, Department of Human Services Director Cindy Gillespie and CMS Administrator Seema Verma. 

Gov. Asa Hutchinson announced Monday that the federal Centers for Medicare and Medicaid Services (CMS) has approved the State’s request to implement a work requirement for Arkansas Works enrollees. With this approval, Arkansas becomes one of only three states that currently mandates work for people seeking health benefits funded by Medicaid expansion dollars. Hutchinson said the change promotes personal responsibility and will help low-income Arkansans move up the economic ladder.

“I have often said that Arkansans understand the dignity of work,” Hutchinson said in a statement on Monday. “The approval of this work requirement will go a long way to create opportunities for able-bodied, working-age Arkansans to enter into training or employment and ultimately climb the economic ladder.

“With federal approval of this requirement, Arkansas has become a national leader in rethinking the delivery of public assistance,” the governor added. “Although Arkansas’ work requirement is one of the most stringent in the nation, it is not designed to be punitive, but to better serve the needs of Arkansans by creating pathways for individuals to take steps toward financial independence. CMS, under the leadership of Administrator [Seema] Verma, understands this and has been a great partner in these efforts. I appreciate the work of all those who have put in long hours designing a program that is better tailored to serve and improve the lives of Arkansans.”

CMS Administrator Seema Verma was in Arkansas on Monday for the governor’s announcement.

“The Trump administration is dedicated to advancing policies that make Medicaid a pathway out of poverty by empowering states like Arkansas to design programs that meet the unique needs of their citizens,” Verma said. “We owe it to Americans all across this country to support new ideas and innovative solutions to improve health outcomes that can promote upward mobility and an improved quality of life.”

Arkansas Works uses Medicaid expansion dollars to buy private health insurance for eligible individuals. Last summer, the Arkansas Department of Human Services submitted to CMS an 1115 waiver request to implement a work requirement, and the two agencies have spent the past several months finalizing terms and conditions for the new requirement.

Arkansas has had a “work referral” process in place over the last year, tracking the outcomes for people who are referred to Department of Workforce Services for assistance in job search and training.  The results of the referral showed that individuals who take advantage of these services are more likely to find a job than those who do not. Shifting from a voluntary “referral” to a mandatory requirement that individuals work in order to receive their health insurance is expected to increase the number of enrollees who take advantage of state programs to assist in developing skills and obtaining jobs.

“DHS is moving to immediately implement the work requirement for Arkansas Works,” Arkansas Department of Human Services Director Cindy Gillespie said. “We’ll notify enrollees this month that their health benefit is now subject to a work requirement and the first group of enrollees will begin reporting on their work activities in June. We’re working with the health insurance carriers, the Department of Workforce Services, Arkansas Foundation for Medical Care, the education community and many others to have a robust program that connects people with resources that can help them meet the work requirement. Work and community engagement is a positive factor for a healthy life and we’re excited to help our fellow Arkansans improve their skills and get new or better jobs because we know that can change their lives for the better.”

Arkansas Works enrollees who are 19 to 49 years old will be subject to the work requirement. The requirement will be phased in on the 30-49 year-olds first over a four-month period between June and September of 2018.  Individuals subject to the work or community engagement requirement must report 80 hours of work activity every month or show that they are exempt from reporting work activities.

A work activity can include a job, job training, job searching, school, health education classes, or volunteering/community engagement (or a combination of any of these for a total of 80 hours). Activity must be reported online at  If an enrollee fails to meet the work or community engagement requirement for any three months in a calendar year, he or she will lose Arkansas Works coverage for the remainder of that calendar year.

An enrollee is considered exempt if he or she is medically frail, exempt from SNAP work requirement, receives TEA assistance, pregnant, caring for an incapacitated person, short-term incapacitated, in substance abuse treatment or full-time education, has a minor child in his/her home or already works at least 80 hours a month.

According to DHS estimates, the work requirement could save the state roughly $50 million annually. Another proposed change to restrict eligibility to 100 percent of the poverty level, rather than 138 percent, could save the state an additional $300 million. All told, both changes would likely remove another 60,000 Arkansans from the state’s Medicaid roles.

See the complete letter from the Department of Health and Human Services here.

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