{"id":16695,"date":"2018-09-13T01:29:35","date_gmt":"2018-09-13T01:29:35","guid":{"rendered":"http:\/\/arknews.org\/?p=16695"},"modified":"2018-09-13T18:17:21","modified_gmt":"2018-09-13T18:17:21","slug":"work-requirement-bars-over-4000-from-states-medicaid-program-in-first-round-of-coverage-losses","status":"publish","type":"post","link":"https:\/\/arknews.org\/index.php\/2018\/09\/13\/work-requirement-bars-over-4000-from-states-medicaid-program-in-first-round-of-coverage-losses\/","title":{"rendered":"Work requirement bars over 4,000 from state\u2019s Medicaid program in first round of coverage losses"},"content":{"rendered":"
\"\"
DEFENDING WORK REQUIREMENT: Governor Hutchinson.<\/figcaption><\/figure>\n

 <\/p>\n

Governor Hutchinson announced Wednesday that 4,353 Arkansans have lost health care coverage for the remainder of 2018 due to three months of noncompliance with the state\u2019s first-of-its-kind Medicaid work requirement. Those beneficiaries are now locked out of the Arkansas Works program for the rest of the calendar year, though they can re-apply in January. <\/span><\/p>\n

Earlier this year, the Trump administration approved Arkansas\u2019s request to impose a work requirement on certain beneficiaries of the Medicaid expansion, composed of low-income, non-elderly adults. Under Hutchinson\u2019s direction, the Arkansas Department of Human Services began the new policy in June. The DHS is rolling out the mandate in phases, but eventually, about 167,000 people ages 19 to 49 will be required to report 80 hours of \u201cwork activities\u201d each month or else show an exemption. (A majority should qualify for an exemption.) Research shows most Medicaid expansion beneficiaries are already working, but to stay in compliance with the requirement, they must also report their hours each month through an online portal created by the DHS.<\/span><\/p>\n

The governor said Wednesday that his aim is not to remove beneficiaries from Arkansas Works.<\/span><\/p>\n

\u201cI\u2019d like to see those that are being cut off from the system lower. We\u2019d like to see them all in compliance,\u201d he said.<\/span><\/p>\n

However, Hutchinson also noted that terminating coverage for those beneficiaries will save the state money. Under Arkansas\u2019s unusual approach to Medicaid expansion, beneficiaries are provided with private insurance plans (sold by carriers on the individual marketplace, such as Arkansas Blue Cross and Blue Shield), and the Medicaid program pays their premium and other cost-sharing. The average monthly premium is about $570.<\/span><\/p>\n

\u201cIn this instance, 4,350 times the $570 per month insurance cost results in a $30 million cost to the taxpayers to maintain,\u201d Hutchinson said. \u201cI think it would be common sense judgment of the people of Arkansas that we should not continue to pay $30 million per year for that cost.\u201d<\/span><\/p>\n

Most of those who lost coverage in September did so because they failed to report any work activities at all for June, July and August. Hutchinson listed a few scenarios that might result in people not reporting. \u201cOne, they could have \u2026 obtained other insurance coverage,\u201d he said. \u201cOr it could be that they moved away out of state without notifying DHS. Or it could be that they simply don\u2019t want to be part of the workforce. They\u2019re able-bodied, but \u2026 \u00a0they don\u2019t desire to do it.\u201d<\/span><\/p>\n

Critics of the work requirement say some people may be unaware it applies to them or may be under the mistaken impression that simply working regularly \u2014 as opposed to reporting those hours \u2014 is enough to stay in compliance. Others may have difficulty reporting online; Arkansas has among the lowest internet access rates in the nation. The governor said he hoped that was not the case, noting the large volume of letters, phone calls and emails sent by the DHS in an attempt to inform beneficiaries of the new policy. In response to a question about the online-only reporting system, he said the insurance carriers are providing \u201cregistered reporters\u201d authorized to receive beneficiaries\u2019 information over the phone and assist them in logging hours.<\/span><\/p>\n

The goal of the requirement, Hutchinson said, is to push more low-income people into the workforce, adding that \u201cmore than 1,000 Arkansas Works enrollees have found employment\u201d allegedly due to the mandate. He cited the story of a woman in Harrison who received notice of the requirement, sought assistance at an Arkansas Workforce Center and is now enrolled in school to become a licensed practical nurse while working one day per week. (Educational hours also satisfy the terms of the mandate.)<\/span><\/p>\n

\u201cI think there are a great deal of success stories,\u201d he said. However, because most Arkansas Works beneficiaries already do work \u2014 and because low-income people often cycle in and out of employment \u2014 \u00a0it is not clear whether the job gains the governor cited were due to the requirement.<\/span><\/p>\n

Earlier on Wednesday afternoon, Democratic gubernatorial candidate Jared Henderson held a press conference criticizing the new rule. <\/span>\u201c<\/b>We have become the first state in the country to impose an internet requirement to create a new bureaucracy between some of our most vulnerable citizens and their access to health insurance,\u201d Henderson said.<\/span><\/p>\n

In the past, Henderson said, Arkansas has led the way in expanding insurance coverage \u2014 a reference to the state\u2019s establishment of ARKids insurance for children under Republican Governor Mike Huckabee and its more recent embrace of Medicaid expansion under Democratic Governor Mike Beebe, making it an outlier among Southern states. <\/span><\/p>\n

Now, he said, \u201cI see us leading in the opposite direction.\u201d<\/span><\/p>\n

The coverage losses reported in September are almost certain to multiply, in part because the DHS is rolling out the requirement gradually. In June, a first cohort of about 27,000 beneficiaries became subject to the mandate. Of that group, about one in six did not report 80 hours of work activities for June, July and August, resulting in their termination this month. If a similar ratio should hold true for the entire 167,000 eventually subject to the requirement, tens of thousands could lose Medicaid in the months ahead.<\/span><\/p>\n

\u201cA pretty significant portion of the population has now lost coverage, when you look at the number of people who are required to report,\u201d Marquita Little, health policy director for Arkansas Advocates for Children and Families, said in an interview after the press conference. \u201cWe know that number is going to continue to increase as the state phases in the work requirement.\u201d<\/span><\/p>\n

The DHS has sent a letter<\/a> to those individuals who recently lost coverage informing them that they are locked out of Arkansas Works until the end of the year. If they failed to report due to \u201can emergency or serious life-changing event\u201d or due to a technical error \u2014 the DHS reporting portal has experienced problems recently \u2014 they may still request a \u201cgood cause\u201d exemption from the agency.<\/span><\/p>\n

Otherwise, unless they now qualify for another Medicaid category or assistance on the individual insurance marketplace, they have no obvious insurance coverage options. For those who have newly joined the ranks of the uninsured, the letter suggests they visit a community clinic or a federally qualified health center to seek medical care.<\/span><\/p>\n

Little said that was not a sufficient solution. \u201cI think our health care system has changed significantly in response to Medicaid expansion,\u201d she said. \u201cThe charity care system is not what it once was. I worry about a large group of people becoming uninsured and that system being unable to absorb an increase in the number of people they\u2019re serving.\u201d<\/span><\/p>\n

\u201cIf one of the main issues is that people aren\u2019t receiving the information about it \u2014 if they\u2019re not getting the mail or if they don\u2019t understand the notices \u2014 continuing to do that probably won\u2019t be effective,\u201d she added.<\/span><\/p>\n

Meanwhile, the Arkansas work requirement remains the subject of a federal lawsuit seeking to halt its implementation. The plaintiffs, who are three Arkansas Works beneficiaries, say the state is attempting to undermine the goals of the Medicaid expansion by throwing up roadblocks to coverage; they say the Trump administration erred in approving a waiver that allowed Arkansas to proceed with its plan. Earlier this year, a similar suit in Kentucky succeeded in blocking that state\u2019s work requirement program before it got off the ground.<\/span><\/p>\n

But Hutchinson says the work requirement will only improve the Arkansas Works program. <\/span><\/p>\n

At his Wednesday press conference, the governor said the requirement represents a \u201cproper balance of those values that we hold important to us in Arkansas.\u201dHe reiterated his support for Arkansas Works as a whole and noted that he has defended it from fellow Republicans who have sought to defund the program. <\/span><\/p>\n

\u201cI fought hard to maintain Arkansas Works, despite odds against it, despite enormous criticism,\u201d Hutchinson said. \u201cCompassion and common sense says this is a good program for those that are trying to move up the economic ladder and to better themselves. It\u2019s also about providing assistance to those who need it. And it is also about the value of work and responsibility.\u201d<\/span><\/p>\n

This reporting is made possible in part by a yearlong fellowship sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund. It is published here courtesy of the Arkansas Nonprofit News Network, an independent, nonpartisan project dedicated to producing journalism that matters to Arkansans. Find out more at arknews.org.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

  Governor Hutchinson announced Wednesday that 4,353 Arkansans have lost health care coverage for the remainder of 2018 due to three months of noncompliance with the state\u2019s first-of-its-kind Medicaid work requirement. Those beneficiaries are now locked out of the Arkansas Works program for the rest of the calendar year, though they can re-apply in January. […]<\/p>\n","protected":false},"author":2,"featured_media":16696,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-16695","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-care"],"yoast_head":"\nWork requirement bars over 4,000 from state\u2019s Medicaid program in first round of coverage losses - Arkansas Nonprofit News Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/arknews.org\/index.php\/2018\/09\/13\/work-requirement-bars-over-4000-from-states-medicaid-program-in-first-round-of-coverage-losses\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Work requirement bars over 4,000 from state\u2019s Medicaid program in first round of coverage losses - Arkansas Nonprofit News Network\" \/>\n<meta property=\"og:description\" content=\"  Governor Hutchinson announced Wednesday that 4,353 Arkansans have lost health care coverage for the remainder of 2018 due to three months of noncompliance with the state\u2019s first-of-its-kind Medicaid work requirement. 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