Arkansas Medicaid work rule blocked as budget bill weighed

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LITTLE ROCK, Ark. — A judge blocked Arkansas’ work requirement for its Medicaid expansion Wednesday as lawmakers debated the future of the expanded coverage program that has sharply divided Republicans over the past several years.

Republican Gov. Asa Hutchinson said he was disappointed in the federal court ruling against the work requirements in Arkansas and Kentucky, but offered no details on what the state’s next steps would be. Hutchinson, who advocated for the requirement, planned a news conference Thursday to discuss the decision.

The ruling came out shortly after the state Senate narrowly voted to keep the Medicaid expansion another year. In a 27-4 vote, the Senate approved the budget for Medicaid and the expansion program. The bill now heads to the 100-member House, where it will need at least 75 votes to win approval.

The Republican leader of the state Senate said the decision doesn’t necessarily jeopardize the expansion’s future, and said officials will need to review the ruling to see if there’s a way to reinstate the requirement.

“I don’t think there’s any reason for the state to panic,” Senate President Jim Hendren said. “This is another obstacle in our path to try to do the best we can in Arkansas with the chips the federal government and the judiciary gives us.”

More than 18,000 people lost coverage last year in Arkansas because of the state’s work requirement, which only applies to its expansion program and not regular Medicaid. Those who lost coverage could re-apply for the program in January. More than 6,400 people were at risk of losing their coverage by April if they didn’t comply with the requirement to work 80 hours a month.

Those who fail to comply three months in a calendar are kicked off the program and can’t regain coverage until the next year. About half of the nearly 234,000 people on the state’s Medicaid expansion were subject to the work requirement last month.

“This policy was designed to make it harder for low-income Arkansans to keep coverage, and unfortunately it was very successful while it was in place,” said Rich Huddleston, executive director of Arkansas Advocates for Children and Families.

Arkansas’ expansion program, which uses federal and state funds to purchase private insurance for low-income residents, has sharply divided the majority-Republican Legislature since it was created in 2013. Before Wednesday’s ruling, some Republican lawmakers urged colleagues to hold off on taking up the program’s budget until the case was resolved.

″(The work requirement) is the thing that’s made it where I’m ok with Medicaid expansion, where I can at least vote for it,” said Republican Sen. Bob Ballinger, who voted against the budget bill. “That kind of thing is exactly the kind of thing that would make me say we need to stop. We don’t need to move this forward.”

Republican House Speaker Matthew Shepherd said he’ll review the ruling and talk with Hutchinson, legislative leaders and the Department of Human Services to determine if any changes should be considered in how the House proceeds on the budget measure.

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