As many as 4,600 Medicaid recipients in Arkansas have lost their benefits for the rest of this year after failing to meet the state's new work requirements.
Arkansas became the first state ever to implement work requirements, after gaining approval from the Trump administration earlier this year. Under the new rules, which took effect in June, recipients must work, go to school, volunteer or search for jobs for at least 80 hours a month or be stripped of their coverage until the following year.
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The affected beneficiaries, mainly non-disabled adults in their 30s and 40s who don't have dependent children, failed to report any work activity for three months. This prompted the state to drop them from the rolls. A final tally will be available next week.
State officials said they made many efforts to contact those subject to the new requirement, including sending letters and emails, making phone calls and videos, working with community organizations and setting up a call center to answer questions. Those who could not find employment were offered training. Recipients had to log their hours online, but could designate certain others -- such as their Medicaid insurer or a local nonprofit -- to do it for them if they did not have access to a computer.
Consumer advocates, however, pointed to the results as proof that work requirements do not help people find jobs. They just add more hurdles for people to get government assistance.
"So far, Arkansas Works doesn't seem to be incentivizing work at all," Joan Alker and Maggie Clark, at the Center for Children and Families at Georgetown University, wrote in a recent blog post. "However, what does seem clear is that the new approach (and others like it) will likely result in significant coverage losses for adults who rely on Medicaid coverage for their survival."
Governor Asa Hutchinson said that some who did not comply may have found work, gained coverage elsewhere or moved out of state without notifying officials.
"Personal responsibility is important," said Hutchinson, a Republican. "We will continue to do everything we can to ensure those who qualify for the program keep their coverage, but we will also make sure those who no longer qualify are removed."
Roughly 46,000 Medicaid enrollees were originally estimated to be subject to the work requirements in July, according to the latest state data. (Those ages 19 to 29 will become subject to the new rules next year.)
More than 30,000 of these recipients were already meeting the mandate by working or engaging in other activities so they were exempted from reporting each month. Several thousand more received other exemptions or had their cases closed for unrelated reasons.
Only 844 met the reporting requirement. Of these folks, 145 said they were working and 127 reported they were in school, volunteering or searching for jobs. The rest reported that they were meeting the work requirements for food stamps, which also satisfies the new Medicaid mandate.
These figures show that the new rules prompted only a sliver of enrollees to find jobs or other activities, Alker said in an interview.
Many recipients likely don't know about the mandate, experts said. Jessica Greene, a professor at Baruch College, found that 12 of the 18 people she interviewed last month had not heard anything about it.
"What I found was a profound lack of awareness about the policy," wrote Greene in a Health Affairs post, who said a much broader educational effort is needed.
Three consumer groups are suing the Trump administration in an effort to halt the Arkansas program. The National Health Law Program, along with Legal Aid of Arkansas and the Southern Poverty Law Center, filed the lawsuit in US District Court in Washington D.C. in mid-August. It charges that approval of Arkansas' waiver runs counter to Medicaid's objective of providing the poor with access to health care.
Consumer activists successfully stopped the implementation of work requirements in Kentucky in June. The Trump administration has also approved requests to implement work requirements in Indiana and New Hampshire, though the new rules have yet to take effect in those states.