Seema Verma, the head of the Centers for Medicare and Medicaid Services, signs paperwork at the state Capitol in Little Rock on March 5 to give the state permission to require that thousands of people on its Medicaid expansion seek ways to work or volunteer. (Kelly P. Kissel/AP)

Opponents of the Trump administration’s changes to Medicaid, who recently persuaded a federal judge to block those changes in Kentucky, have filed a similar lawsuit aimed at Arkansas.

In June, Arkansas became the first state to begin phasing in requirements that thousands of poor residents must work at least 80 hours a month, look for a job, or otherwise engage in their community to start receiving Medicaid or keep it. The suit, filed Tuesday on behalf of three poor Arkansans with significant medical problems, seeks to stop those rules.

It contends that the administration’s approval of the state’s plan is unconstitutional, violates Congress’s power and undermines the basic purpose of the safety-net program created in the 1960s as part of President Lyndon B. Johnson’s War on Poverty.

In language echoing the challenge in Kentucky, the suit accuses the administration of “overturning a half century of administrative practice, and threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country.”

The suit was filed in the U.S. District Court for the District of Columbia by the National Health Law Program and the Southern Poverty Law Center, both of which are involved in the Kentucky litigation, as well as Legal Aid of Arkansas. It names as defendants the Department of Health and Human Services, its Centers for Medicare and Medicaid Services, and their top officials.

The case heightens attention to the philosophical divide over the compact between the government and the nation’s poor. Conservatives, including the administration’s senior health officials, say that Medicaid recipients should be required to fulfill certain obligations, such as work requirements, and that such activities would lift people out of poverty and government reliance. Liberals regard the health-care program as a right for anyone who is eligible, and they maintain that access to care is an underpinning for poor people to improve their lives.

Two months after administration officials said they were open to work requirements, Arkansas in March became the third state to win federal permission.

But it was the first to implement the new rules, beginning in June with residents ages 30 to 49. They are among 125,000 Arkansans who joined Medicaid through an expansion under the Affordable Care Act who will eventually need to comply, unless they qualify for several kinds of exemptions. Over the next few months, younger adults will be phased in under the rule.

About 46,000 people needed to meet the requirements during the first two months, the state reported Tuesday, but nearly 13,000 did not. Almost 5,500 were noncompliant for two consecutive months, the figures show. If someone does not follow the rules for three months, they are removed from Medicaid for the rest of that year.

The lawsuit notes that to report work or document the basis for an exemption, Arkansans must submit monthly information online. The suit contends that is “a difficult, if not impossible task for plaintiffs on a regular basis due to lack of Internet access, trouble using computers, and problems working with the online portal.”

U.S. District Judge James E. Boasberg ruled in the Kentucky case that administration officials had been “arbitrary and capricious” in approving the requirements without adequately considering their effect on beneficiaries.

“We are undeterred,” HHS Secretary Alex Azar said in July. “We’re fully committed to work requirements and community participation in the Medicaid program.”

The groups filing the new suit are asking that it be given to Boasberg on the grounds that it is a related case, rather than being assigned to any judge on the court.

“This lawsuit has one goal, which is to undermine our efforts to bring Arkansans back into the workforce, increase worker training, and to offer improved economic prospects for those who desire to be less dependent on the government,” Gov. Asa Hutchinson (R) said in a statement, accusing the plaintiffs of “trying to thwart any effort to transform and bring accountability to our Medicaid program.”

Federal health officials said they could not comment on pending litigation.