The Government Stepped Back in Arkansas. Who Was Supposed to Be There All Along?

What happens when a government program designed to help actually hurts the people it’s meant to serve? Bethany Herron breaks down a 2019 New England Journal of Medicine study on Arkansas’ first-year Medicaid work requirements—and the results may surprise you. From massive coverage loss to little impact on employment, this episode uncovers what distant programs miss—and how local communities can step in to truly help.

What You’ll Learn:

• 18,000 People Lost Medicaid: Administrative hurdles—not laziness—drove most coverage losses.
• Private Insurance Picked Up Some Slack: 40% found alternative coverage, showing some independence—but many fell through the cracks.
• Employment Didn’t Increase: Work requirements didn’t meaningfully boost jobs. Most participants were already working or exempt.
• Local Solutions Win: Churches and community programs can provide childcare co-ops, food support, and work-ready initiatives where government programs fail.
• Subsidiarity Matters: People closest to the need are best positioned to solve it—local, relational action beats top-down bureaucracy every time.

Resources & Links:

• Read the full study: Medicaid Work Requirements — Results from the First Year in Arkansas
• Read our full analysis. 
• Explore True Charity’s programmatic resources for building local impact at truecharity.us. 

This educational content is just the tip of the iceberg for practical resources available through the True Charity Network. Check out how it can help you learn, connect, and influence here.

Already a member? Access all your benefits through the member portal.