Senior Policy Analyst
Some 4,109 Arkansas Medicaid beneficiaries lost coverage on October 1 for not reporting at least 80 hours of work or work-related activities for three months, the state reports. That brings the total to 8,462 beneficiaries who have lost coverage since the state implemented its rigid work requirement. These individuals are locked out of Medicaid for the rest of 2018 even if they report 80 hours of work or work-related activities in future months or become exempt from the requirement due to illness or other reasons.
Over 16,000 beneficiaries (23 percent of those subject to the work requirement) didn’t report sufficient work hours in September (see chart). Almost 5,000 beneficiaries now have two months of non-compliance with the work requirement and will lose coverage if they don’t report 80 hours of work or work-related activities for another month this year. And another 7,500 have one month of non-compliance and will lose coverage if they have two more non-compliance months. Thousands of them will likely lose coverage in the coming months.
Good cause exemptions, which are available for beneficiaries who can’t comply or report compliance due to circumstances beyond their control, don’t appear to be protecting vulnerable beneficiaries. In September, Arkansas’ Medicaid agency granted only 140 good cause exemptions for August — though over 16,000 beneficiaries didn’t comply with the reporting requirement that month. Good cause exemptions were available for beneficiaries who couldn’t report due to a statewide computer outage that affected the online reporting portal on the last day to report compliance in September, but few beneficiaries apparently knew it was available. Like other provisions of the work requirement, beneficiaries bear the burden to know the exemption exists, understand that they qualify, and email a request to the agency, which may be hard for beneficiaries with limited Internet and email access.
A new Kaiser Family Foundation brief, based on interviews with state officials, health plans, providers, and beneficiary advocates, details some of the factors that are likely leading eligible Medicaid beneficiaries to slip through the cracks and lose coverage in Arkansas:
As we’ve explained, research suggests that only a small minority of Medicaid beneficiaries potentially subject to the state’s work requirement aren’t already working and wouldn’t qualify for an exemption. The Arkansas experience thus far shows that many eligible beneficiaries who are working or qualify for an exemption are nevertheless getting caught up in the complex policy and restrictive reporting requirements and losing coverage.