On Friday, Mike DeWine kept his pledge to support the Medicaid expansion. Recall he went from opponent to backer during the campaign last year. The governor included in his first two-year state budget plan the program that has brought health care coverage to roughly 700,000 Ohioans living near the poverty level. At the same time, he received word from the federal government: The state can move forward with its proposal, ordered by the Republican legislative majorities, to impose work requirements on many now benefiting from the expansion.

In this instance, too, the governor has made a pledge. He has promised a requirement that “would not be punitive in any way.” That is a standard to which he and lawmakers should be held, especially in view of what has happened in Arkansas, which already has implemented a work requirement and seen many recipients lose coverage though they remain eligible.

The governor and others who favor the work requirement seek to reassure that they are focused on able-bodied adults, building skills and expanding opportunity. The requirement does exempt those who are age 50 and older, who are parent caretakers, have chronic conditions or are physically or mentally unfit to work. Yet the circumstances easily can get complicated and risk harmful unintended consequences.

The state has projected that 18,000 recipients will lose their Medicaid coverage. The concern is, and the results in Arkansas indicate, the number could run much higher. Why? The work component involves a complex set of reporting requirements for tracking whether recipients are meeting the necessary 80 hours per month of work. Put another way, fail the paperwork, and coverage could be lost.

The reporting is difficult, in part, because many recipients work in such areas as retail, restaurants and construction in which the hours are variable, leaving no guarantee of meeting the required threshold. So these recipients are working, but they are vulnerable to losing health coverage, anyway.

More, the reporting factor promises an added administrative burden for county governments. The Center for Community Solutions, a Cleveland-based think tank, has projected the cost at nearly $380 million the next five years. Sound familiar, the state adding strains to local budgets?

All of this has been proposed in the context of the Medicaid expansion receiving high marks. Since its adoption, the rate of Ohioans without health coverage has dropped 45 percent. The number who skip care because of the expense has declined by more than one-quarter. Hospitals have seen the cost of uncompensated care fall 50 percent. Recipients are healthier and less likely to face a choice between medicine and food or rent or other basics.

Research generated independently by the state found that the expansion actually helps in searching for work and keeping a job.

With that in mind, it is worth stressing, again, that the large majority of those covered by the expansion already work, and most of those who do not work qualify for an exemption. That means the work requirement involves the pursuit of a tiny sliver of recipients, with incomes below 138 percent of the poverty level. They aren’t gaming the system somehow. This is health care, not a tax credit or food assistance. Medicaid comes into play when people are sick or managing their care and thus avoiding higher costs.

Now the early signs from Arkansas point to a work requirement making matters worse, the minuses plain, the gains less clear. The lesson for Ohio isn’t just about taking care in the implementation. It goes to the standard the governor set. Perhaps the one way to avoid a punitive work requirement is not to have one at all.