'Needless and Ideologically-Driven Cruelty': Arkansas to Become First State to Implement Trump's Assault on Medicaid

The Trump administration is waging a vicious war on Medicaid--a program that provides life-saving healthcare to around 74 million Americans--and its effects will soon be felt in the state of Arkansas.

"Today's Arkansas plan breaks new ground in needless and ideologically-driven cruelty."
--Brad Woodhouse, Protect Our CareOn Monday, Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma--who, prior to joining the Trump White House, helped craft Indiana's punitive Medicaid restrictions--hand-delivered and signed a federal waiver granting Arkansas permission to begin imposing work requirements on the state's Medicaid recipients, 60 percent of whom already work.

According to state officials, the measure will go into effect June 1, which would make Arkansas the first state to implement Medicaid work requirements.

In an article on Monday, Vox's Dylan Scott made clear that Arkansas' plan amounts to just a fraction of the broad nationwide attacks on Medicaid launched by red states, which are "putting the lifeline for millions of poor Americans at risk."

"The stakes are huge: Work requirements for food stamps have been linked to substantial drops--up to 50 percent in some isolated cases--in the program's enrollment," Scott observes. "As many as 25 million people could be subject to Medicaid work requirements if they were instituted nationwide. In a very real sense, health coverage for millions of Americans who rely on Medicaid could be at risk under the agenda Trump is advancing."

While Arkansas' Republican Gov. Asa Hutchinson insisted at a press conference that his plan "is not about punishing anyone," analysts argued that is precisely what it will do.

Citing provisions in the Arkansas waiver that will require those with disabilities to "prove" they are exempt from work requirements every two months and other forms of red tape, Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities (CBPP), argued in a blog post on Monday that the measure is "certain" to increase "the gaps in coverage, worsen health outcomes, and possibly increase state costs."

Brad Woodhouse, director of the advocacy group Protect Our Care, denounced Arkansas' plan as "draconian" in a statement following Hutchinson's announcement.

"By imposing onerous monthly paperwork requirements on working people and forcing Arkansans with disabilities to re-prove their exempt status every two months, today's Arkansas plan breaks new ground in needless and ideologically-driven cruelty," Woodhouse said.

Numerous analyses have found that paperwork requirements like those proposed by Arkansas and other states will likely lead to thousands of eligible people losing health insurance.

As Common Dreams reported, the Trump administration paved the way for states to impose work requirements on Medicaid recipients in January by issuing guidance that granted states the ability to make healthcare contingent upon certain "performance" metrics, such as hours spent working or training for a job.

"As many as 25 million people could be subject to Medicaid work requirements if they were instituted nationwide."
--Dylan Scott, Vox

Since the guidance was issued, three states have had work requirements approved and eight other states have applied for federal waivers. According to Verma, nine additional states have expressed interest in applying for a waiver.

Under Arkansas' plan, if Medicaid recipients fail to comply with the new rules--which require recipients to work, look for a job, or participate in job training for at least 80 hours a month--for a period of three months, they will lose coverage for the rest of the calendar year.