The Trump administration’s Centers for Medicare and Medicaid Services has sent a guidance to state Medicaid directors that aligns with part of Arkansas’ request for a waiver for its Arkansas Works program.

Amy Webb, Arkansas Department of Human Services spokesman, said the department received the letter, dated Jan. 11, that morning. It is not an official approval but does offer guidance.

“We are pleased that the administration has put out this guidance saying it will give states more flexibility to do the kind of reforms we have planned in Arkansas,” she said. “We expect official approval of our waiver request soon and are prepared to implement the changes we’ve requested.”

Gov. Asa Hutchinson’s administration asked for the waiver from the Trump administration as part of its ongoing efforts to administer Arkansas Works, the program that uses federal Obamacare dollars to purchase private health insurance for lower-income Arkansans.

The letter, whose existence was reported by Fox News, says CMS will “support state efforts to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility.”

It acknowledges that the agency is shifting its stance from one under the Obama administration that did not require work or community engagement. It says applications will be reviewed on a case-by-case basis.

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