The Arkansas Department of Human Services will expand the reporting options for the state's controversial Medicaid work requirements program, which resulted in over 12,000 people losing their Medicaid eligibility until 2019.
Beginning Dec. 19, Medicaid beneficiaries can report their work hours over the phone, seven days a week. This expansion of reporting options changes one of the most criticized aspects of the state's work requirements program: The majority of reporting was required to be done over the internet.
Since the state implemented its work requirements program in June, opponents of the program have said that requiring people to record their hours on the Arkansas DHS website was hurting low-income people who may not have access to a computer or the internet. In addition, Arkansas is currently ranked 46th in the country for internet connectivity, according to US News and World Report.
Arkansas' program operates on a three-strike model. Medicaid recipients are required to work or participate in community engagement activities like school or volunteering for at least 80 hours per month, and people would record these hours on the agency's website. If someone does not meet these requirements for three total months in a calendar year, they lose Medicaid eligibility until the following year.
A total of 12,277 people have lost Medicaid eligibility since the program began, and another 6,002 were in danger of losing their coverage at the beginning of November. The Arkansas DHS has not yet released November's data.
Medicaid beneficiaries also can report their hours directly to an insurance carrier or to someone who has been trained by the Arkansas DHS to record hours.
The state agency has also said that staff will monitor those who have begun to report their hours but have not finished, and the staff will be reaching out to the enrollees to encourage them to continue reporting, according to a Dec. 12 press release.
The changes come a little over a month after the Medicaid and CHIP Payment and Access Commission, a nonpartisan congressional advisory committee, asked the U.S. Department of Health and Human Services Secretary, Alex Azar, to pause and review the program.
One of the main concerns highlighted by the commission was the requirement to record hours over the internet. The Arkansas DHS has claimed that there were multiple ways that people could report their hours, but MACPAC said in the letter that the state was unable to provide them with any figures showing how many people had done this.
Cindy Gillespie, director of the Arkansas DHS, said in the Dec. 12 press release that the agency wanted to make changes before 2019 when more people will be required to follow the policy. Currently, Arkansas' program only pertains to 30- to 49-year olds. Beginning January 2019, the requirements will expand to 19- to 29-year-olds as well.
Gillespie added that the changes are expanding the already established policy of being able to report hours over the phone.
CMS continues to defend Arkansas' program
The Centers for Medicare and Medicaid Services Administrator, Seema Verma, has continually defended it as a way to help people find employment. Gillespie has echoed a similar defense as Verma, and told S&P Global Market Intelligence in October that the state has no plans to stop the program, even if the number of people who get kicked off of Medicaid continues to rise.
The number of people gaining employment is significantly lower than those losing their Medicaid eligibility, according to data released by the Arkansas DHS on Nov. 15.
The data show 1,525 people met the work requirement in October. However, 968 of them were already meeting the state's work requirements under the Supplemental Nutrition Assistance Program. A total of 557 new people fulfilled the work requirement for October, while 3,185 lost Medicaid eligibility.
Arkansas' program is currently facing a lawsuit that claims the requirements hurt Medicaid beneficiaries. The same federal judge who blocked Kentucky's work requirements from taking effect is overseeing the lawsuit.
Arkansas is the only state that has implemented a work requirements program, but four other states have had a program approved by CMS and 10 states currently have waiver pending, according to the Kaiser Family Foundation, a nonpartisan healthcare policy organization.
Both Indiana and New Hampshire are scheduled to roll out their programs at the beginning of 2019.