Arkansas and Missouri could both see significant declines in Medicaid coverage under new federal work requirements set to take effect next year, according to a new report.
The analysis from the Urban Institute, supported by the Robert Wood Johnson Foundation, finds enrollment losses will vary widely depending on how states enforce the rules.
Under stricter policies, Arkansas is projected to see a 37% to 46% drop in its Medicaid expansion population. Missouri could see steeper losses, with enrollment declines reaching 60% or more.
The changes stem from a federal law signed by President Donald Trump requiring many recipients to document work or qualify for exemptions.
Nationwide, between 4.9 million and 10.1 million people could lose coverage by 2028. Even among those already working, 19% to 37% may be dropped due to reporting and paperwork requirements.
States must begin enforcing the new rules by January, with final impacts largely dependent on how strictly each state applies the requirements.
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