Work rule trips up 7,000-plus Arkansas Works enrollees

Failure to comply puts their coverage at risk after 3 months

Posted: July 14, 2018 at 4:30 a.m.

A chart showing work requirement compliance.

More than 7,000 Arkansas Works enrollees were found out of compliance with a work requirement that took effect last month, according to figures released Friday.

The enrollees were among the first group of participants in the Medicaid expansion program required to spend 80 hours a month on work or other approved activities unless they qualify for exemptions.

Enrollees who don't qualify for automatic exemptions, based on information in state records, must use a state website to report on their activities or exemption status.

The requirement took effect in June for an initial group of 25,815 enrollees aged 30-49 and is being phased in through September for the remaining enrollees in the age group who have incomes of up to the poverty level.

Enrollees who fail to meet the requirement for three months during a year will lose their medical coverage for the rest of the year.

Gov. Asa Hutchinson called the first report on compliance "encouraging."

"We are only two months in, and those on Arkansas Works are still learning the system," Hutchinson said in a statement.

The state Department of Human Services "has worked hard to make sure that everybody understands the requirements and how to comply," he added.

Arkansas in March became the third state to receive federal approval to add a work requirement to its Medicaid program, and last month it became the first state to implement one.

A federal judge blocked a work requirement for Kentucky's program that would have taken effect this month, saying the Trump administration hadn't adequately considered the effect the measure would have on enrollees' health care.

When fully implemented, Arkansas' requirement will apply to about 167,000 people enrolled in Arkansas Works, which covers people who were made eligible by the expansion of the state's Medicaid program in 2014.

The expansion extended eligibility to adults with incomes of up to 138 percent of the poverty level. Currently that income cutoff is $16,753 for an individual or $34,638 for a family of four. Most enrollees receive the coverage through private insurance plans, with the Medicaid program paying the premiums.

The work rule is being phased in for enrollees ages 30-49 this year and for those ages 19-29 next year. Almost 275,000 people were covered under the program as of June 1.

Out of more than 27,000 enrollees who were notified in May that they would become subject to the work requirement the next month, 1,325 had left the program by June, leaving 25,815 who were subject to the requirement, according to the Human Services Department.

Of that group, 15,511 were automatically exempted based on information in state records. Such exemptions apply, for instance, to enrollees living with dependent children or who earn at least $736 a month. That cutoff is based on the average monthly income of someone making the state's minimum wage of $8.50 an hour and working 20 hours a week.

Of the remaining 10,304 enrollees, 2,395 used the website, access.arkansas.gov to report other types of exemptions.

For instance, 187 enrollees were exempt because they were receiving unemployment benefits, 164 reported that they were temporarily incapacitated, 128 were caring for incapacitated people, 79 were being treated for substance abuse and 24 were enrolled full time in school or job training programs.

Only 445 used the site to report that they met the requirement through work or other approved activities. That included 351 who reported that they were in compliance with a separate work requirement for food stamp recipients.

Arkansas Works enrollees who meet the food stamp work requirement are considered to be in compliance with the Arkansas Works requirement.

Just 73 enrollees reported their work hours, which are calculated based on how much money each enrollee reports earning. Twenty-seven enrollees reported volunteering, 18 reported hours spent looking for work and eight were part-time students in school or training programs.

Of the 7,464 who did not meet the requirement, 423 had left the program by July 8, leaving 7,041 who were still in the program with one month of noncompliance.

Marquita Little, health policy director for Arkansas Advocates for Children and Families, said the number who failed to comply points to the need for more outreach.

Many enrollees likely would have qualified for exemptions or were working, but didn't know about the requirement or how to use the website, she said.

"I think it signals that there's just a lot more work to do, and we need to start thinking about what this will look like in the fall," when some enrollees could be kicked off the program after three months of noncompliance, she said.

Human Services Department spokesman Amy Webb said the department has been trying to reach enrollees through letters, emails, phone calls and messages on social media platforms.

She noted that the three insurance companies that offer Arkansas Works plans can log into the website on behalf of their customers to report work activities or exemptions. More than a dozen other organizations are also offering the assistance, she said.

"We want more people to go on and report their activities," she said. "The numbers show that a lot of people didn't. We'll continue to try to reach them and encourage them to do that, but at some point they do have to take some action to keep their coverage."

A Section on 07/14/2018