Medicaid work rule goes unnoticed
The Trump administration argues that imposing work requirements for Medicaid is an incentive that can help lift people out of poverty. But a test program in Arkansas shows how hard it is merely to inform people about new incentives, let alone get them to act.
In the first month that it was possible for people to lose coverage for failing to comply, more than 4,300 people were kicked out of the program for the rest of the year. Thousands more are on track to lose health benefits in the coming months. People lose coverage if they fail to report three times and the program, in effect for three months, is slowly phasing in more people.
Advocates for the poor, and the state officials in charge of the program, said the low compliance numbers suggested that many eligible people probably did not know the program existed. State officials said they worked hard to get the word out — mailing letters, sending emails, placing phone calls, briefing medical providers, putting posts on social media sites and distributing flyers where Medicaid patients might find them.
Arkansas is the first state to test a work requirement, a policy that the administration has encouraged and that several other states are hoping to copy. The demonstration project is testing whether a work requirement can help encourage more low-income people to work, volunteer or go to school and improve their financial prospects.
The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours.
Of the remaining third — about 20,000 people — 16,000 did not report qualifying activities to the stte. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, aIt is hard to measure how many people opened paper mail, but the state noted in its recent report that it knows that thousands of people in the program either move away from their recorded address or fail to answer other mail from the state.