Arkansas governor vows not to give up on Medicaid work rules

But Arkansans who lost coverage due to Medicaid work rules should reapply for coverage, as the state won't re-enroll them.

Former Drug Enforcement Administration Administrator and U.S. Congressman Asa Hutchinson (L) take the podium after NRA CEO and Executive Vice President Wayne LaPierre's news conference at the Willard Hotel December 21, 2012 in Washington, DC. (Photo by Alex Wong/Getty Images)
Former Drug Enforcement Administration Administrator and U.S. Congressman Asa Hutchinson (L) take the podium after NRA CEO and Executive Vice President Wayne LaPierre's news conference at the Willard Hotel December 21, 2012 in Washington, DC. (Photo by Alex Wong/Getty Images)

Arkansas officials remain fully committed to the state’s Medicaid work requirements despite being dealt a heavy blow from a federal judge who blocked the first-ever policy. Gov. Asa Hutchinson (R) said during a press conference Thursday that he asked the Trump administration to appeal the federal judge’s decision.

“I believe there should be consequences if people do not exercise responsibility,” he told reporters.

On Wednesday, a federal judge blocked the Trump administration’s most consequential health policy, Medicaid work requirements, in Arkansas and Kentucky. District Judge James “Jeb” Boasberg called the requirements “arbitrary and capricious,” as they don’t serve the central objective of Medicaid, which is to “furnish medical assistance to its citizens.”

“First of all, Judge Boasberg did not strike down work requirement based upon the reporting elements that has created significant controversy,” said Hutchinson.


“He did not reach that question because he had a fundamental disagreement with the work requirement in and of itself… I contend that Judge Boasberg is wrong and I’m urging Department of Justice and [Department of Health and Human Services] Secretary Azar to appeal the ruling and seek an expedited appeal of the District Court’s decision.”

“No appeal decisions have been made yet,” said a Department of Health and Human Services spokesperson, in a statement to ThinkProgress.

The governor added “we are in this for the long haul” and that the president and his administration are also committed to its work requirement.

Boasberg’s decision means residents in Arkansas and Kentucky don’t have to worry about work requirements — at least for now. The 10 Medicaid enrollees in Arkansas who sued federal and state officials over the requirements were thrilled by the news.

“Relieved is a big theme as well because one thing that doesn’t come up in the discussion is all the stress and worry that comes from not knowing if you’re going to have health care next week or next month,” Kevin De Liban, an attorney with Legal Aid of Arkansas, said of his clients. “They were all happy and all so relieved because now they know they will have health care.”


But undoing the harm caused by the work requirements in Arkansas, where the policy went into effect in June 2018, will be challenging. Already over 18,000 residents in Arkansas lost coverage last year due to the new rules. Residents who lost coverage were able to re-enroll beginning January 1, but only 1,452 of the 18,164 residents who were booted off the Medicaid rolls re-applied.

“Nobody knows they can sign up,” De Liban told ThinkProgress.

“[The State] is prohibited by law from spending any money to inform people that they can sign up for Medicaid expansion. So all these people have been cut off and then they haven’t been informed really that they can sign back up.”

Liban says the next step for advocates on the ground will be letting residents know they can sign up for health care, adding that residents could call Legal Aid of Arkansas if they run into any problems. Arkansas Attorney General Leslie Rutledge confirmed in a press statement that state officials won’t automatically re-enroll anyone:

“Judge Boasberg’s decision… does not require that the Arkansas Department of Human Services automatically re-enroll any of those individuals in the program. Arkansans must reapply if they want coverage. Additionally, individuals who have not complied with the work and community engagement requirement from January to March 2019 cannot be removed from the program for noncompliance going forward.”

Meanwhile, Kentucky officials weren’t planning to implement the state’s Medicaid changes until April 1.

Another concern is what the decision means for Medicaid expansion in both states. Kentucky Gov. Matt Bevin (R) threatened to end expansion if he doesn’t get his way with regard to implementing work requirements. But Ian Heath Gershengorn, the attorney arguing on behalf of Arkansas and Kentucky Medicaid recipients, recently told reporters that the governor does not have the authority to unilaterally end the expansion, citing state law.

Advocates in Kentucky will be watching out for attempts to undermine the lawsuit victory. There’s a possibility lawmakers will try to pass legislation on Thursday, the last day of the General Assembly. That legislation would effectively let the governor end Medicaid expansion.


“Our main task today is to make sure that doesn’t happen — that it doesn’t show up in any legislation, you know, running down the lock until midnight,” said Dustin Pugel, policy analyst for the Kentucky Center for Economic Policy.

There’s also a chance the governor will undermine Medicaid, as he did the last time that Boasberg blocked Medicaid work requirements by ending dental and vision benefits, he added. But Pugel remains optimistic.

“In February of 2015, governor then candidate Matt Bevin put out a platform that essentially said that on day one he was going to end the entire Medicaid expansion. And here we are, four years later, and we still have the entire Medicaid expansion barrier free,” Pugel told ThinkProgress.

In Arkansas, state senate lawmakers approved funding on Wednesday for its Medicaid program. The governor said funding for the program shouldn’t be at risk.

The Trump administration has been trying to reshape the country’s largest public health program by conditioning reported work on eligibility, even though there are no studies demonstrating that the policy is successful in getting people out of poverty and into a job where they can receive employer-based insurance. Indeed, there is plenty of evidence to show that the policy is inherently flawed because many enrollees who can work do work, but in low-wage service jobs with limited benefits.

The Department of Health and Human Services (HHS) already approved work requirements in eight states, after officials in those states sought federal approval for the policy. HHS official Seema Verma says the administration isn’t discouraged despite the legal setbacks. “We will continue to defend our efforts to give states greater flexibility to help low income Americans rise out of poverty,” she said in a statement on Wednesday.

While it looks as if the administration will continue to approve work requirements, it’s unclear if states will continue to ask the federal government for permission to implement those requirements. Measures seeking to enact Medicaid work requirements in Idaho and Iowa stalled after Wednesday’s decision.