07/13/2026
MEDICAID “WORK RULE”: SPEAK NOW
What’s this about working while on Medicaid ARHOME benefits? What’s my ailing mom supposed to do?
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Starting next year, many ARHOME enrollees — low-income Arkansans aged 19 to 64 — must prove they’re working 80 hours a month to keep their Medicaid health insurance. “Work” can mean a job, job training, community service, or school.
Arkansas tried something similar once, but it didn’t pan out. The state had hoped to promote self-sufficiency and program integrity. But 18,000 people lost coverage, with no evidence that anyone had been encouraged into a job. So the courts halted the program.
Now Congress tries again. This time enrollees might be excused if they're “medically frail” or have other “special medical needs.” But a federal agency has layered on an even stricter, but vague, standard: the illness must also “significantly impair” the “ability to comply with the community engagement requirement,” or, in other words, the ability to “meet ordinary demands.”
But what might “significantly impair” mean? Would arthritis or a bad back qualify? An inability to handle online reporting paperwork? Nobody knows yet.
Advocates fear that just like before, the sick will be dropped from Medicaid simply because of undefined bureaucratic hurdles. Twenty-five states and the District of Columbia have sued. If they win, “significant impairment” won’t apply to them. But Arkansas isn’t in that suit, so we’ll just have to see how our authorities interpret the phrase. It’s been reported that they’re working on an automated process to check eligibility. In other words, a computer program would decide.
The work requirement is now the law of the land. “Significant impairment,” however, is open for reconsideration, but for a short time only. The public is invited to comment until July 31st.
So hurry. For suggestions on what to write, search online for “disabilitybelongs.org” and “action center.” Then search “regulations.gov CMS-2026-2047-0002 comment.” Click on the blue box and let them hear from you.
Then help your mother prepare. If she can’t work, gather documents to show why not. If she is working, track her hours. Starting in January, she will likely need proof either way.