A Tale of Two States: Reconciling Medicaid Work Requirement Enrollment Impacts in Georgia and Arkansas

Morgan Henderson, Laura Spicer and Alice Middleton

AEA Papers and Proceedings, 2026, vol. 116, 326-330

Abstract: Medicaid work requirements have reemerged as a major federal policy, yet evidence on their enrollment effects is sparse. We reconcile sharply different outcomes from the only two states that implemented Medicaid work requirements: Arkansas, which reported high compliance, and Georgia, where enrollment has remained extremely low. We distinguish theoretical eligibility from observed enrollment and show that administrative reporting design is a first-order determinant of enrollment under Medicaid work requirements. Using monthly Medicaid enrollment data from Arkansas, we document a strong relationship between manual reporting and noncompliance and show that Georgia’s fully manual system yields enrollment consistent with this mechanism.

JEL-codes: H75 I13 I18 I38 (search for similar items in EconPapers)
Date: 2026
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DOI: 10.1257/pandp.20261089

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