Arkansas has removed thousands of individuals from its Medicaid program for failing to comply with work requirements — a first in the 53-year history of the federal health insurance program for the poor.

More than 4,300 Medicaid recipients in Arkansas have lost coverage after failing to meet the state's new work requirements, which were approved by the Trump administration and took effect in June.

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“Personal responsibility is important. We will continue to do everything we can to ensure those who qualify for the program keep their coverage, but it is equally important that we make sure those who no longer qualify are removed," said Arkansas Gov. Asa Hutchinson.

A total of 4,353 individuals have been booted from the program for not reporting to the state how they're meeting the requirements or for not working enough hours. Under the new program, those who are out of compliance three months in one year become ineligible for coverage the remainder of the year.

The state's Department of Human Services said it conducted outreach from April through August to let beneficiaries know about the new requirements.

But "some simply chose not to comply. Those are the ones who will lose their Arkansas Works coverage for the remainder of 2018," Hutchinson said.

According to numbers provided by the state, only 1,218 beneficiaries subject to the requirement worked 80 hours and reported that to the state in August.

Another 16,357 people didn't meet the requirements last month, meaning more people could lose coverage in the coming months.

Opponents of work requirements have long said that people would lose coverage not because they weren't working, but because they weren't reporting to the state.

A total of 40,190 people were exempt from reporting because they were already meeting the requirement, had a dependent child in the home, were pregnant, medically frail or other reasons.

In Arkansas, the work requirements only apply to Medicaid beneficiaries between the ages of 19 and 49 who gained coverage through ObamaCare's Medicaid expansion.

The National Health Law Program filed a lawsuit in August against the administration for approving the program, alleging that work requirements violate federal law and will "gravely harm thousands of Arkansans." That same group won a lawsuit against the administration for approving work requirements in Kentucky, halting the program there earlier this summer. The judge who ruled against the administration in the Kentucky lawsuit will also oversee the suit involving Arkansas. In his Kentucky ruling, U.S. District Judge James Boasberg ruled that the Department of Health and Human Services never "adequately considered" whether the requirements would help the state "furnish medical assistance to its citizens, a central objective of Medicaid." The administration is working on finding a way forward for work requirements in Kentucky, and opened a new comment period to show it was trying to address the judge's concerns. The administration has also approved Medicaid work requirements in Indiana and New Hampshire. Applications for work requirements are pending in South Dakota, Kansas, Mississippi, Ohio, Maine, Utah and Arizona. The Arkansas Works program is the subject of a lawsuit filed by health care advocates in D.C.

Updated at 4:48 p.m.