Federal Judge Blocks Arkansas Medicaid Work Requirement

Mar 27, 2019

Gov. Asa Hutchinson detailing proposed changes to the state's Medicaid expansion program on March 6, 2017, which included the addition of a work requirement. A federal judge Wednesday blocked the requirement. In a written statement, Hutchinson said he was disappointed with the decision and would offer additional comments at a press conference Thursday.
Credit Michael Hibblen / KUAR News

A federal judge has ruled that work requirements under the Arkansas Works program are not legal and called for an immediate halt to that element of the program. The ruling could have significant budget implications for the state.

In a ruling issued late Wednesday, U.S. Federal Judge James Boasberg said the work requirement element applied in 2018 to Arkansas’ Medicaid system is not legal. He rejected claims by the state that striking down the provision would be disruptive.

“Weighing the harms these persons will suffer from leaving in place a legally deficient order against the disruptions to the State’s data-collection and education efforts due to vacatur renders a clear answer: the Arkansas Works Amendments cannot stand,” Boasberg ruled.

The judge also noted in his ruling that “the State’s outreach efforts may well be falling severely short” with respect to notifying Medicaid enrollees of how to maintain their status.

In 2018, 18,164 enrollees lost coverage for failing to meet the requirement. Of those, 1,452 of those recipients gained coverage in 2019, including 1,441 of them in Arkansas Works. More than 13,000 recipients of the state’s Arkansas Works program did not meet its work requirement in February, while 6,472 recipients could lose their benefits if they fail to meet the requirement another month this year.

Nine Arkansans filed suit in U.S. District Court, saying the federal executive branch bypassed the legislative process and acted on its own to “comprehensively transform” Medicaid. The plaintiffs are represented by Legal Aid of Arkansas, the National Health Law Program, and the Southern Poverty Law Center.

Originally known as the “private option,” Arkansas Works was created by legislators and Gov. Mike Beebe’s administration in 2013. It was created after the U.S. Supreme Court ruled states could choose whether or not to expand their Medicaid populations under the Affordable Care Act, otherwise known as Obamacare.

Many Republican-leaning states chose not to expand their populations. Arkansas did, but instead of simply expanding Medicaid, it used mostly federal funds to purchase private health insurance for those lower-income individuals.

After Gov. Asa Hutchinson was elected, he embraced the program, helping it each year attain the 75% support required in both the Arkansas House and Senate for funding. Some lawmakers remain skeptical of the program.