Arkansas is Kicking Thousands Off Medicaid

If you have a few minutes to watch the story of Adrian McGonigal, you will quickly see why Arkansas’s strict work requirements are not working.

Since September, nearly 17,000 individuals in Arkansas have been kicked off their Medicaid health insurance as a result of stringent requirements to report certain work-related activities. As Montana heads into its legislative session where continuing Montana’s successful Medicaid expansion program will be a key topic of debate, it is worth looking at what is happening in Arkansas as a result of these harsh new requirements. In just the first few months of implementing Arkansas’s work requirement, over 12,000 low-income individuals lost health care coverage. We learned recently that another 4,655 Arkansas lost their coverage in December because they have not reported at least 80 hours of work-related activities in the previous three months.

These Arkansans are the first in the country to lose Medicaid benefits as a result of strict work requirements. Rather than using state resources to help people access work support and workforce training, Arkansas’s new policy only serves to take health care coverage away from people when they most need it. Earlier this year, a federal judge struck down Kentucky’s similar requirements, determining these work requirements are not in line with the core objectives of Medicaid to provide affordable health care coverage to families living in poverty. (Kentucky refiled their waiver, and the federal Health and Human Services again approved it in November 2018. This updated plan, which differs little from the previous proposal, will again be reviewed by the court.)

With additional data on Arkansas, state policymakers should look closely at the effect of these provisions. The cumbersome requirements in Arkansas do more to create additional paperwork than it does to create employment. The vast majority of Medicaid beneficiaries who can work are already working. Out of the 69,743 beneficiaries in the Arkansas Works Program who were subject to the work requirement in October, 55,388 were exempt from reporting their activities because they were already meeting the requirement due to work, training, or other activities.

In October, 10,768 Arkansan Medicaid beneficiaries were required to report work activities, which until January 2019, only includes those aged 30-49. In this month, only 1,428 people (just 13 percent) were able to report satisfying the reporting requirement. An additional 914 newly filed for exemptions.

Out of the remaining 8,426 beneficiaries, only 118 people reported some activities but not enough to satisfy the 80 hours/month requirement. This could mean that many people who did not report satisfying the requirement did not know about the new regulations or were unable to create accounts and navigate the online portal. As a result, these individuals have lost health care coverage.

Before, Arkansans facing a difficult time could rely on Medicaid for health care coverage. Workers with low-incomes who had been struggling to get enough hours at their job or had been recently laid off were able to maintain health care coverage and avoid compounding their financial difficulties. But with this new policy in place, families with low-incomes face a ticking clock before losing their health insurance.

While the new reporting requirements in Arkansas have not significantly changed the number of Medicaid beneficiaries who are working, they have resulted in thousands of people losing their health care coverage. Losing health care can make it more difficult for people facing serious illnesses to return to work in the future.

In January, Arkansas will expand its requirements to new populations, including those aged 19 to 29 and eventually to American Indians. Thus, we can expect even more Arkansans losing health care coverage if the state keeps in place these harsh requirements.

Montana’s voluntary workforce program, HELP-Link, has been successful at assisting individuals to address work-related barriers and find employment. This more individualized approach allows people to keep their insurance and better enables them to find work. Stay tuned for another blog on Montana’s successful HELP-Link program coming tomorrow, and MBPC will continue to closely track the effects of harsh requirements in Arkansas and elsewhere.

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