Trump Rejected Arkansas’ Medicaid Waiver. The Clock Is Now Running.
The Trump administration declined to renew the waiver that funds Arkansas’ Medicaid expansion, putting coverage for more than 200,000 low-income Arkansans at risk when the program expires at the end of 2026. The state’s expansion, currently called ARHOME, has operated under a premium-assistance model unique among states. Without a new federal agreement, that model cannot continue.
Arkansas has requested a two-year temporary waiver to keep the program running while a longer-term solution is negotiated. Federal officials have not approved it.
200,000+ low-income Arkansans enrolled in ARHOME who could lose health coverage if the program expires
Health providers and policy experts are warning of severe consequences if coverage ends. Arkansas already ranks among the states with the fewest hospital resources per capita, and the expansion has been credited with cutting the state’s uninsured rate and reducing the cost hospitals absorb for treating uninsured patients.
Arkansas Needs a Three-Fourths Vote to Save the Program
Arkansas expanded Medicaid in 2013, becoming the first Southern state to do so and the first in the nation to use private insurance subsidies to cover expansion enrollees. Passing it required a three-fourths supermajority in both chambers of the legislature, a threshold one governor called as hard to reach as “motherhood and apple pie.” Republicans who voted for it have repeatedly faced primary challenges from the right.
That same political math applies now. Any budget fix that preserves ARHOME requires the same supermajority. Supporters face a more hostile legislative climate in 2026 than they did in 2013, with no clear path to the votes needed.
The program has survived a dozen years of repeal attempts, procedural fights, and gubernatorial maneuvering. The Trump administration’s waiver refusal is the most direct federal threat it has faced.
What You Can Do Now
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Call your Arkansas state senator and representative at the Arkansas Legislature’s main line at (501) 682-6107 and tell them to support renewing ARHOME. Say specifically: “I want you to vote yes on any budget measure that keeps ARHOME funded through 2027.” The program expires December 31, 2026, and a legislative vote could come before the end of the year.
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Contact Arkansas Governor Sarah Huckabee Sanders’ office at (501) 682-2345 and urge her to pressure federal officials to approve the two-year temporary waiver. The state submitted the waiver request; the governor’s office can escalate it publicly with CMS.
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Find your specific Arkansas legislators at arkleg.state.ar.us and look up their stated position on ARHOME. Members who voted against the expansion in recent sessions are the key targets for constituent pressure.
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Connect with Arkansas Advocates for Children and Families at aradvocates.org, which is tracking the waiver fight and publishes alerts when votes are scheduled.
Sources
Arkansas Advocate: Arkansas’ Medicaid Expansion Is Endangered Again KFF: Arkansas ARHOME Medicaid Waiver Overview and Enrollment Data KFF: Medicaid Expansion Enrollment by State Brennan Center: State Supermajority Rules and Budget Obstacles