4,100 people lose coverage of health plan

Oct. 1 terminations second under work requirements

More than 4,100 people lost their Arkansas Works coverage this month in the second round of terminations resulting from failure to meet the program’s work requirement, according to a state Department of Human Services report released Monday.

The terminations, which took effect Oct. 1, bring to more than 8,400 the number of people who have been locked out of the program until the end of December for either failing to spend 80 hours a month on work or other approved activities or failing to report what they had done. Enrollees must report via a state website.

Enrollees found out of compliance for three months during a year are cut from the program and barred from re-enrolling for the rest of the year.

The first round of terminations, which took place last month, resulted in 4,353 Arkansans being locked out of the program. An additional 4,109 were locked out this month, the Human Services Department reported Monday.

Partly as a result of the terminations, enrollment in the program from Sept. 1 to Oct. 1 fell by more than 5,800 people, to 252,642, the department reported.

Meanwhile, 4,841 more enrollees who were still on the program as of Oct. 8 had accumulated two months of noncompliance.

They will lose coverage Nov. 1 unless they use the website to report their work hours or an exemption for this month.

Gov. Asa Hutchinson said in a statement that the Arkansans who were locked out of the program “have either found work, moved onto other insurance, moved out of state without notifying DHS, or chose not to comply.

“We have gone to great lengths to ensure that those who qualify for the program keep their coverage,” he said.

The requirement “allows us to concentrate resources on those who need it most rather than continuing to pay insurance premiums on those who no longer qualify,” he said.

Jared Henderson, the Republican’s Democratic opponent in the Nov. 6 election, issued his own statement saying the requirement “jeopardizes our rural hospitals and their staff as thousands will be receiving uncompensated care after losing their health insurance.”

“Arkansans know that access to quality health care allows them to show up for work and provide for their families, and this internet requirement is a bureaucratic barrier to that success,” Henderson said.

The state began phasing in the requirement, the first such requirement ever added to a state’s Medicaid program, for Arkansas Works enrollees in June.

The program covers people who became eligible for Medicaid when Arkansas extended eligibility in 2014 to adults with incomes of up to 138 percent of the poverty level.

The income cutoff this year, for instance, is $16,753 for an individual or $34,638 for family of four.

Most enrollees receive the coverage through private plans, with the Medicaid program paying most or all of the premium.

The requirement was phased in from June through September for enrollees age 30-49 and will be added next

year for those age 19-29.

Of the 73,266 enrollees subject to the requirement last month, 52,714, or about 72 percent, were exempt based on information from state records or that the enrollee reported before September.

The remaining 20,552 enrollees were required to use the website, access.arkansas. gov, to report their activities or an exemption. Just 3,795, or about 18 percent, did so.

That included 2,263 enrollees who claimed an exemption and 1,532 who reported a sufficient number of work hours or other approved activities or that they were already meeting the work requirement for food stamps.

The most common reason for an exemption, applied to 25,368 enrollees, was because state records indicated the enrollee’s income was consistent with that of someone working at least 80 hours a month at the state’s minimum

wage of $8.50 an hour.

Among the other exempt enrollees were 9,705 who had an exemption from the food stamp work requirement, 8,020 who were covered by the traditional Medicaid program, rather than a private plan, because they were considered to be “medically frail” and 7,432 who had one or more dependent children in the home.

In a report last week, the San Francisco-based Kaiser Family Foundation said the state’s effort to spread the word about the requirement through phone calls, emails and messages on social media, had failed to reach many enrollees.

The health policy research organization described the process for reporting work activities or exemptions as “complicated” and said a lack of computer literacy and Internet access created a barrier for many enrollees.

Kevin De Liban, an attorney with Legal Aid of Arkansas, said the latest numbers don’t indicate that awareness of the requirement has been increasing.

For instance, he noted that the 18 percent of nonexempt enrollees who used the state website to report their hours or an exemption last month compared to 28 percent of nonexempt enrollees who did so in June.

The Jonesboro-based organization is helping with a lawsuit arguing that federal authorities failed to follow federal law when they approved the requirement.

A similar suit by two of the organizations involved in the Arkansas case resulted in a judge’s order that stopped a work requirement from taking effect in Kentucky in July.

“These kind of numbers don’t justify a wait-and-see approach,” De Liban said. “They don’t suggest it’s going to get any better.

“If anything it’s going to continue along this line and get worse and that’s where we get the rampant terminations.”

Kathy Grisham, director of the Springdale-based Community Clinic, a federally funded community health center, said she hasn’t heard of any of her patients losing coverage due to the work requirement. But she added, “People don’t come to the doctor every month, so it’s going to take them a while to realize it.”

Meeting the requirement is likely a challenge for many of the center’s Arkansas Works patients, she said.

“We’re talking about a population that, if they had access to computers and were technologically skilled and had good jobs that paid well, they wouldn’t need Medicaid,” she said.

In a report last week, the San Franciscobased Kaiser Family Foundation said the state’s effort to spread the word about the requirement through phone calls, emails and messages on social media, had failed to reach many enrollees.