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Another 4,000 Arkansans lose Medicaid coverage due to work requirements program


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Essential IR Insights Newsletter - February 2023

Another 4,000 Arkansans lose Medicaid coverage due to work requirements program

New data from the Arkansas Department of Human Services shows that over 4,000 more people have lost their Medicaid eligibility until 2019 due to the state's controversial work requirements program, bringing the total number of people who have lost coverage to 8,462.

The new requirements went into effect in June, making September the second month that Medicaid recipients could have lost their coverage for not meeting the minimum work requirements. According to the data, which was released Oct. 15, 4,109 people lost their coverage at the end of September, and another 4,841 are at risk of losing coverage next month.

Arkansas is the only state that has implemented a work requirements program, which features a three-strike model. The state requires Medicaid recipients to work or participate in other activities such as school and volunteering for at least 80 hours a month. If someone does not meet these requirements for three total months in a calendar year, they lose coverage until the following year.

Critics of the new requirements have questioned if people in the state were properly informed of the changes before they took effect.

A new report from the Kaiser Family Foundation found that despite a "robust effort" from the state to inform people of the changes to the Medicaid program, a large number of individuals in Arkansas were still not contacted about work requirements going into effect.

One of the primary ways people were notified was over the phone, but Kaiser noted that some enrollees do not have a number listed, while others had an incorrect number or simply did not pick up the phone or respond to voicemail messages. The study said that about 21,000 total Medicaid enrollees were called in May and June, but the Arkansas DHS has said that about 76,000 people were subject to work requirements in September.

Governor defends work requirements

Republican Gov. Asa Hutchinson acknowledged that the program was controversial in September but defended the program as a way to help people get jobs. Seema Verma, the Centers for Medicare and Medicaid Services administrator, echoed the same defense in a Sept. 27 speech and said the programs are "not some subversive attempt to just kick people off of Medicaid."

However, questions about the program's effectiveness have been raised, with critics wondering if the program actually leads to employment. According to the state's Oct. 15 data, 1,532 Medicaid recipients met the work requirements in September, but 1,025 were already meeting similar requirements for the state's Supplemental Nutrition Assistance Program, leaving just over 500 new people fulfilling the state's requirements.

Despite the early data coming out of Arkansas, Verma reaffirmed the agency's support for work requirements in the September speech and said CMS will "not draw rash conclusions after only a few months of data and information."

Work requirements have not traditionally been a part of Medicaid; however, CMS told state Medicaid directors in January that the agency will work with states that want to implement them.

While Arkansas is the only state to implement a program, Kentucky, Indiana and New Hampshire have had their programs approved by CMS via a waiver request, and 10 states have waivers pending, according to data from the Kaiser Family Foundation.

Kentucky, the first state to have a work requirements program approved, saw its program blocked by a federal judge in June because as many as 95,000 people could have lost coverage if it were implemented. A similar lawsuit has been filed in Arkansas and is being overseen by the same judge that made the Kentucky ruling.