Medicaid work requirements particularly threaten unpaid caregivers who provide essential care for relatives[1][2]. According to AARP, nearly 8 million unpaid caregivers depend on Medicaid for health insurance[1]. These requirements require adults aged 19 to 64 to do at least 80 hours a month of work, training or other skilled activity, with unpaid family care often not recognized as a qualifying condition[2][3]. The Congressional Budget Office estimates that by 2034, they could increase the number of uninsured people by nearly 5 million[1]. In Arkansas, one in four people lost insurance due to administrative requirements in 2018, although employment did not increase[3]. Unpaid caregivers make up 25 percent of direct care workers, compared to 19 percent in the overall occupational group[3]. These changes threaten the home-based long-term care system and may increase the cost of institutional care[1][2].