LITTLE ROCK, Ark. (AP) — Medicaid shutdown fatigue is starting to set in at Arkansas' Capitol.

Despite all the talk of a work requirement being key to keeping the state's Medicaid expansion alive this year, the Trump administration's approval of that new mandate wasn't the deciding factor. Instead, it was the prospect of a months-long standoff over the program.

The Arkansas Senate approved the budget for Medicaid and the expansion program, which uses Medicaid funds to purchase private insurance for low-income residents, a day after federal officials approved the work requirement. Vacancies in...