Arkansas plans to begin enforcing a new work requirement for many Medicaid expansion enrollees on Jan. 1, 2027, after federal officials offered states the option to postpone enforcement for six months.
The requirement applies to the state’s Arkansas Health and Opportunity for Me program, commonly known as ARHOME. The program covers adults ages 19 to 64 with incomes up to 138% of the federal poverty level. Under 2026 guidelines, that limit is $22,024 for an individual or $44,550 for a family of four.
Almost 209,000 Arkansans were enrolled in ARHOME as of Nov. 1, according to an Arkansas Department of Human Services official. Keith Metz, acting communications chief for the department, said Friday that Arkansas was continuing to prepare for the start-of-the-year implementation.
The federal Centers for Medicare and Medicaid Services said states could use a voluntary “hold harmless” period through June 30. The agency described the option as time for states to improve their systems before enforcement begins.
“Gives states the ability to improve and refine their systems and processes before enforcement begins, supporting long-term success of the work requirement.”
Under the Arkansas requirement, many ARHOME beneficiaries must complete a combined 80 hours each month through work, education or volunteering. The requirement stems from the One Big Beautiful Bill Act, which President Donald Trump signed last year and which requires states to implement work requirements for Medicaid expansion beneficiaries.
Groups excluded from the requirement
Some beneficiaries are exempt under the current policy. The exemptions listed by the state include:
- Pregnant and postpartum women;
- Former foster children younger than 26;
- People considered medically frail;
- Parents or caregivers of children younger than 14;
- Tribal members or Alaska Natives;
- Veterans with a “total disability” rating; and
- Arkansans enrolled in Medicare.
Arkansas previously received federal approval to impose a work requirement on some Medicaid expansion enrollees in 2018. The policy resulted in thousands of people losing coverage at the time, according to the account of the earlier program, and a federal judge later struck it down.
The current requirement is being developed under the federal law rather than the earlier waiver. Federal officials said the six-month option was available to states that wanted additional time to refine their systems and procedures, while Arkansas officials said they would maintain the Jan. 1 implementation schedule.
