The Arkansas Senate passed Senate Bill 527 by a 27-0 vote on Tuesday, advancing legislation to allow Governor Sarah Huckabee Sanders’ administration to seek reauthorization of the state’s Medicaid expansion program, ARHOME, under President Trump’s administration. The bill includes a work requirement for eligible recipients and other changes to improve cost-efficiency and sustainability.
The legislation proposes several reforms, such as increasing the medical loss ratio from 80% to 85%, capturing pharmaceutical rebate funds, and implementing a "Pathway to Prosperity" amendment with success coaching and personal development plans. The requirement would apply to ARHOME participants aged 19–64 and include exemptions for caregiving and other hardships. Noncompliant individuals could have coverage suspended, but it may be reinstated upon cooperation.
The state estimates the work requirement would save $122.8 million over five years, despite costing $42.8 million to implement. Arkansas is one of several states with a trigger law that ends Medicaid expansion if federal match funding drops, though Sen. Missy Irvin expressed confidence that such a change is unlikely.