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Governor Sarah Huckabee Sanders directs DHS to add work requirement to Medicaid program

02/15/2023

LITTLE ROCK, Ark. – Gov. Sarah Huckabee Sanders announced Wednesday that she has directed the Arkansas Department of Human Services (DHS) to implement a work requirement for able-bodied adults who receive enhanced Medicaid coverage under the Medicaid expansion program known as Arkansas Health and Opportunity for Me, or ARHOME.  

“Today, I am announcing that, under my direction, Secretary Putnam will be submitting a request to the federal government to require ARHOME recipients to work, go to school, or volunteer,” Sanders said. “This will address our state’s workforce challenges and empower thousands of Arkansans to escape the trap of government dependency.”   

ARHOME provides Medicaid coverage for more than 300,000 adults who have incomes below 138 percent of the federal poverty level. Most ARHOME beneficiaries receive their coverage through health insurance that Arkansas Medicaid purchases from qualified health plans available on the Arkansas Health Insurance Marketplace.   

Under the plan announced today, able-bodied adults enrolled in ARHOME will be required each month to engage in activities such as working a full- or part-time job; participating in higher education; or participating in skills or trades training.  

DHS Secretary Kristi Putnam, who serves on the recently created Governor’s Workforce Cabinet, noted that this new Medicaid work requirement is a key part of that effort aimed at ensuring that the state workforce is prepared for high-wage, high-growth careers. The Workforce Cabinet will integrate all of the state’s workforce programs and ensure a holistic approach to helping these Medicaid beneficiaries achieve economic stability.   

“This work requirement challenges those enrolled in ARHOME to embrace economic opportunities that can lead to true job advancement,” Putnam said. “Meaningful work connects people to purpose – and through the pandemic we have seen negative mental health impacts from people feeling disconnected. I’m excited both to spearhead this new program and to support it through the work of the Workforce Cabinet, which strives to make sure all Arkansans have access and opportunity to compete for meaningful careers with good pay and health coverage.” 

Arkansas law already allows DHS to use qualified health plan enrollment as an incentive for economic independence. Beneficiaries who choose not to participate in the workforce development component would remain covered under Medicaid, but they will receive benefits through fee-for-service providers rather than the enhanced coverage offered by qualified health plans. 

Implementation of the work requirement will require an amendment to the ARHOME Section 1115 Medicaid Demonstration Waiver, which must be approved by the federal Centers for Medicare and Medicaid Services (CMS). DHS plans to publish a draft waiver amendment by April 23, allowing for a 30-day public comment before the amendment is formally submitted for approval. The proposed effective date for the amendment is Jan. 1, 2024. 

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