Arkansas became the third state to win the Trump administration's permission to compel tens of thousands of residents on Medicaid to work or prepare for a job beginning in June, 2018 during a press conference held Monday March 5, 2018 in Little Rock.

Arkansas was one of the few Southern states to expand Medicaid under the Affordable Care Act, when it told federal officials it wanted to set its expansion limit at 100 percent of proverty, instead of the 138 percent of the federal poverty line as designed in the ACA. A change that could drop an estimated 60,000 people from the program. The poverty level line request was denied. However the work requirement was approved.

Governer Asa Hutchinson spoke about his plan for to begin phasing in the work requirements more quickly than other states. The new requirements, targeting people ages 19 - 49, compel people to have a job, be in school or volunteer for at least 80 hours per month. They will need to document every month that they are fulfilling the rules. A person who fails to do so for three months will be removed from the program and locked out until the next year. The requirements will apply to able-bodied adults unless they qualify for an exemption because they care for a young child, are pregnant, are medically or mentally unfit to work, or are being treated for addiction, among other reasons.

The requirement will begin in June for people ages 30 - 49, according to a the Department of Human Services. The state estimates that nearly 40,000 of the 98,000 Medicaid expansion recipients will need to comply. The requirements for the younger recipients will begin in 2019.