6,400 enrollees face coverage loss over Medicaid work rule

More than 6,400 Arkansas Works enrollees as of last week were on track to lose their coverage unless they report on their compliance with the program’s work requirement by the end of this month.

Those enrollees failed for two successive months, January and February, to meet the requirement to spend 80 hours on work or other approved activities, such as volunteering, and report what they did to the state.

Enrollees who accumulate three months of noncompliance are kicked off the program and barred from re-enrolling for the rest of the year.

“If anything, the numbers just continue the pattern that we’ve been seeing since June of last year, which is that the state has created new hoops for people to get tripped up on and that the state is overwhelmingly successful in forcing people off coverage who need it to maintain work and live a full life,” said Kevin De Liban, a spokesman for Jonesboro-based Legal Aid of Arkansas.

His organization is one of three groups challenging the requirement in a lawsuit in federal court in Washington, D.C.

U.S. District Judge James Boasberg heard arguments Thursday in the case and on a suit challenging a similar requirement in Kentucky and said he plans to rule on both cases by the end of the month, before more Arkansans lose coverage for noncompliance.

The program covers Arkansans who became eligible

for Medicaid when the state expanded it in 2014 to cover people with incomes of up to 138 percent of the poverty level. That income cutoff is $17,236 for an individual or $35,535 for a family of four.

From Feb. 1 to March 1, enrollment in Arkansas Works grew by more than 2,000 people, to 235,962, according to figures released Friday.

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

Attorneys challenging the approval of the work requirements by President Donald Trump’s administration contend that the administration failed to consider the effect the requirements would have on Medicaid’s goal of providing health coverage to low-income people.

The administration has argued that the requirements do support that goal by saving the states money, thus making their Medicaid programs more fiscally sustainable.

Gov. Asa Hutchinson has also contended that many enrollees who have been kicked off the program may have found coverage from another source, such as a spouse’s plan, or moved out of the state.

He has also pointed to figures from the state Department of Workforce Services on the number of enrollees who have started new jobs since the requirement took effect in June.

According to figures released Friday, that number for enrollees age 19-49 was 9,196 as of Feb. 26, including 1,981 who had been terminated from Arkansas Works as of Jan. 30 for noncompliance with the requirement.

De Liban said those numbers are “totally misleading” because they include enrollees who switched from one job to another and don’t indicate whether the new job was a better one than the old one or whether it offers health coverage.

A spokesman for Hutchinson didn’t return calls seeking comment on Friday.

Arkansas was the first state in the more than 50-year history of the Medicaid program to implement a work requirement for some of its enrollees.

The requirement was phased in last year and in January for enrollees age 30-49 and is being added this year for those age 19-29.

From Sept. 1 through Jan. 1, 18,164 enrollees, or an average of 4,541 a month, lost coverage after accumulating three months of noncompliance.

Those enrollees became eligible to re-enroll Jan. 1. The Human Services Department reported Friday that 1,889 have done so. Eleven others were found to be eligible for Medicaid under a category other than Arkansas Works.

Of the 116,229 Arkansas Works enrollees subject to the requirement last month, 13,373 were found to be out of compliance.

All but 197 of those did not report any information on their activities or exemption status to the state.

Among those found to be in compliance, only 693 had reported to a state call center or by using a state website that they completed 80 hours of approved activities.

The other 102,163 enrollees were found to be exempt based on information in state records or that the enrollee reported.

The most common exemption, granted to 52,571 enrollees, was for those whose incomes, based on the state’s minimum wage of $9.25 an hour, indicate they work at least 80 hours a month.

Among other enrollees who qualify for exemptions are those who are exempt from, or are already meeting, the food-stamp program’s work requirement, who are considered medically frail based on their health needs, who have a dependent child in the home, who are attending school full time or who are pregnant.

Of the enrollees who were out of compliance in February, 6,472 also did not comply in January and were still enrolled as of March 7. They will lose coverage April 1 unless they report hours of work or other activities or an exemption for this month.

In addition to Arkansas and Kentucky, five other states have received the Trump administration’s approval to add work requirements to their Medicaid programs. Eight others have submitted applications to add them, according to The Commonwealth Fund, a New York City-based health policy research organization.

Two states, other than Arkansas, have started implementing the requirements. Indiana’s started in January, although the state won’t check on enrollees’ compliance for 2019 until the end of the year.

New Hampshire was scheduled to begin notifying its enrollees about its requirement this month.