A new report from the Georgetown University Center for Children and Families takes a closer look at who will be affected by Medicaid work reporting requirements. The findings raise concerns for families in Arkansas, where Medicaid plays a major role in keeping parents and children covered. As policy changes take effect in 2027, we want to make sure parents have the information they need to understand new requirements.
Because of H.R. 1 (AKA the “One Big Beautiful Bill”), adults enrolled through Medicaid expansion will soon have to regularly report work or other qualifying activities to keep their coverage. In Arkansas, our Medicaid expansion is called ARHOME. More than 200,000 Arkansans get coverage through ARHOME, and the new law will affect this group.
Many of the people affected are parents
The report shows that many adults who will be subject to these requirements are parents, though many other parents should qualify for exemptions. In fact, H.R. 1 requires states to grant exemptions to parents with children under age 14 in the home. Additionally, parents, regardless of the age of their children, should be exempt from Medicaid work reporting requirements if their child has a disability or other condition that requires the caregiver to help the child with daily living activities (this caregiving exemption also applies to caretakers of adult children, parents, or a spouse).
Arkansas has seen this before
Arkansas is not new to work reporting requirements. In 2018, the state required certain adults to report their work hours. More than 18,000 people lost coverage before the policy ended. Most of those people were still eligible. They lost coverage because they did not know about the reporting rules or had trouble using the system. Others should have been granted exemptions but did not receive those exemptions.
The real issue is in systems and paperwork
Most people on Medicaid who can work already do. Others are caring for children, going to school, or dealing with health issues. Some live in areas (like rural Arkansas) with limited job opportunities. The biggest challenge is not that people are unwilling to work. It is that they could lose coverage because of paperwork problems or confusing reporting systems.
Work reporting requirements are often described as a way to encourage employment. But in practice, they function as a paperwork requirement. People have to log hours, submit documents, and navigate red tape. If they miss a step, they can lose coverage.
This is especially hard for people with unstable work schedules, chronic health issues, or changing family situations. Arkansas has already seen how administrative hurdles can lead to large coverage losses in a short period of time.
Arkansas will be “soft launching” its work reporting systems in July, but there are still many questions unanswered about what people will need to do and the full range of exemptions.
What this means for families in Arkansas
In Arkansas, Medicaid programs like ARHOME and ARKids First help parents and children get care when they need it. More than 800,000 Arkansans are covered by Medicaid programs. Nearly half of children in Arkansas rely on ARKids First for insurance, more than 400,000 children. Our Medicaid expansion cut the adult uninsurance rate in half. When parents have health coverage, their children are more likely to have coverage too. This is often called the “welcome mat” effect. That means policies that cause parents to lose coverage can also affect children, even if the children are still eligible.
Because of the stakes for kids and families, it’s important that systems being built by the state can accurately identify parents with children in the home who should be exempted. Systems also need to be responsive to the needs of caretakers of all types, especially non-traditional families (like grandparents or other family members who are guardians to children). Parents and guardians have plenty on their plates already. They shouldn’t have to worry about losing health care over burdensome red tape or errors in verification systems.
Keeping families covered matters
Health coverage helps families stay healthy and financially stable. When people lose coverage, they are more likely to delay care, skip medications, or take on medical debt. For Arkansas, the lesson is clear. Keeping eligible parents covered helps keep kids covered too.
AACF will continue to share information in the upcoming months about work reporting requirements in Arkansas. As this policy is rolled out, it will be important to reduce confusion, limit paperwork barriers, and make sure families do not lose coverage when they are still eligible. Because when parents stay covered, children are more likely to stay covered. And that leads to healthier families across Arkansas.