The Urban Institute issued reports today questioning the implementation and worth of Arkansas’s work requirement for recipients of expanded Medicaid coverage and of Supplemental Nutrition Assistance Program  (food stamp) benefits.

The Medicaid work rule, under challenge in court, has been a demonstrable failure, unless you figure poor implementation and throwing thousands off coverage is a success. (The Asa Hutchinson administration might.)


From focus groups and interviews with providers and others, the Urban Institute concluded as to the Medicaid work rule:

  • Nearly everyone had heard of the work requirements– but most didn’t understand the requirements or thought they didn’t apply to them.

  • The Arkansas Department of Human Services did extensive outreach, but most believed that these efforts (traditional mail and phone calls) did not reach many beneficiaries.

  • Beneficiaries had limited awareness of and difficulty accessing employment and training services.

  • Some focus group participants said challenges navigating the requirements caused them to lose Medicaid coverage, which affected their ability to obtain needed care and prescription drugs.

  • Potential solutions include expanded community-based outreach and education efforts, expanding and simplifying means and methods for reporting work and community engagement activities, and increased funding for work support agencies and infrastructure.

  • However, even if these solutions were implemented, beneficiaries would likely still face barriers to compliance.

 The assessment of the state’s work-related time limits on eligibility for subsidies to buy food was similar.

  • Administrative barriers and unclear communication mean SNAP participants and service providers are confused about how to comply and document compliance for work requirement rules.

  • SNAP participants have limited access to jobs, training, and other support services. Available education and training opportunities are often limited to basic skills and do not help everyone find jobs.

  • Some participants have lost access to SNAP – disrupting their already tight budgets and forcing them to choose between basic necessities.

  • Potential solutions include clearer communication, better access to education and training opportunities, improved transportation infrastructure, and a stronger safety net.

The Urban Institute, in announcing the report, noted a problem that has been noted by others. The poor people targeted by the work rules face numerous barriers to getting and keeping jobs.

For work requirements on public assistance programs to promote sustained employment, states would need a work support service infrastructure that helps people access higher-quality jobs.

Here’s the report on the Medicaid work rule.


Here’s the report on the SNAP work rule, which applies to able-bodied adults without dependents. It was imposed in 2016..