Arkansas Medicaid History and Facts

Initial Medicaid Implementation: The state set up a limited Medicaid program shortly after the passage of the act to pay for nursing home services. Arkansas established its Medicaid program in 1970. Wilbur Mills, the chief Congressman and Ways and Means Chairman that facilitated the passage of the Medicare Act of 1965 hailed from Arkansas.

Key Medicaid Political Issues: Arkansas has historically had the second most restrictive

group of people on top of mountain
Photo by Jordan Benton on

eligibility standards. The 1980’s were largely characterized by reductions in benefits and reimbursement rates in addition to further restrictions through prior authorizations and other barriers. In the 1990’s the state extended coverage to additional children and pregnant women. Throughout the 2000’s Medicaid provided a safety net during recessions but eligibility was very limited and coverage included extensive cost sharing. Prior to the passage of the Affordable Care Act, Arkansas Medicaid did not cover low-income, non-caretaker adults without disability or special condition. In comparison with many other states, the Medicaid program remains a small portion of the state’s budget

Medicaid expansion Implementation: Arkansas expanded Medicaid in April 2013 as part of a legislative compromise between the Republican dominated legislature and the Democratic governor, Mike Beebe. The state was the first to use an 1115 waiver in conjunction with their expansion to allow for premium assistance and the selection of marketplace plans for higher income enrollees. Since the initial implementation of the 1115 waiver the state has continued to add additional requirements to the Medicaid program and have made efforts to restrict eligibility in Medicaid expansion. In June of 2018 Arkansas it became the first state to implement the requirement that Medicaid beneficiaries to work to continue receiving benefits.

General facts about Arkansas Medicaid:

Medicaid program name: Medicaid

CHIP Program name: ARKids

Separate or combined CHIP: Combination

Enrollment: 912,000 (2017)

Total Medicaid Spending: $6 billion (2016)

Share of total population covered by Medicaid: 22%

Share of Children covered by Medicaid: 66%

Share of Medicaid that is Children and Adults: 73%

Share of Spending on Elderly and people with disabilities: 27%

Share of Nursing Facility Residents covered by Medicaid: 66% (estimate)

FMAP: 70.88%

Expansion state: Yes

Number of people in expansion: 303,900 (2016)

Work Requirement: In effect


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