Arkansas becomes first state to implement Medicaid work requirements under Trump 1st-term waiver

Arkansas begins enforcing Medicaid work requirements on June 1, 2018, becoming the first state to implement such requirements after the Trump administration's first term grants a Section 1115 waiver in March 2018 allowing the state to condition Medicaid eligibility on work, job training, or community service for 80 hours per month. By the end of 2018, approximately 18,000 Arkansans lose coverage. A federal district court strikes down the Arkansas waiver in March 2019, finding that the work requirements contradict Medicaid's core purpose of providing medical assistance to low-income people. The D.C. Circuit upholds the district court ruling in 2020. The episode establishes the legal framework that later Medicaid work requirement litigation builds upon.