We reflected Tuesday on this page how one's vantage point often determines whether a particular piece of news can be considered good or bad. That sentiment applies to a multitude of topics, not the least of which is Arkansas Medicaid expansion and whether the GOP-pushed work requirement produces desirable outcomes.
The latest news comes from a report released Monday by the Arkansas Department of Human Services. It said more than 4,100 people lost insurance coverage in October through Arkansas Works, the name given to the state's Medicaid expansion under the Affordable Care Act. That reduction came about from the state's determination that those Arkansans failed to meet the program's work requirement.
What’s the point?
Arkansas’ process for booting lazy people off its Medicaid expansion is reducing the program’s participation, but is that through real data or by just setting up barriers to reporting?
The rule requires those receiving state- and federally supported insurance coverage using Arkansas Works/Medicaid dollars to spend 80 hours a month on work or other approved activities and to report what they've done to the state. Enrollees must report via a state website. Employees found to be out of compliance for three months during a year are cut from the program and barred from re-enrolling for the rest of the year.
So now, Arkansas has reduced its Medicaid rolls through the work requirement by more than 8,400 people.
Supporters of the work requirement laud such cuts, suggesting that it reflects the number of people who are able-bodied but not working. Critics, however, note that Arkansas has terrible broadband access throughout much of the state, and particularly in rural, low-income areas, making it difficult and unlikely that people who otherwise qualify will be able to report to the state via a website.
Another 4,841 people have accumulated two months of noncompliance, so it's likely November will see a similar decline in people covered through Arkansas works. As of the latest report, Arkansas Works still covers 252,642 people.
Gov. Asa Hutchinson said the reductions allow the state to concentrate resources on those who fully qualify instead of paying premiums to private insurers for those who have failed to qualify.
Arkansas got high praise for an innovative approach to Medicaid expansion that uses tax dollars to buy private insurance for qualifying individuals. The program delivered health insurance to many Arkansans who did not qualify for traditional Medicaid but also didn't have coverage through an employer. Delivering health care to the uninsured was killing many smaller hospitals, and leaders within the health care systems across the state credit the Medicaid expansion for reducing the burden of unpaid care that previously served as a financial drag for health care facilities.
We've got no problem with Arkansas insisting that able-bodies individuals either work, pursue job training or devote time to efforts to find employment. But the availability of internet access and even computer skills is a challenge for many Arkansans. It makes no sense that anyone who qualifies for coverage should be removed from the Arkansas Works rolls because they struggle to access the state's website.
Get tough on lazy people unwilling to work? You bet. But can Asa Hutchinson really assert that all the people being slashed from Arkansas works really deserve to get booted from the program? Or has the state simply made it too difficult for regular Arkansans who aren't afraid of work to check in with their government overlords?
Arkansas needs to work on this work requirement issues. Who among the more fortunate would like to see their health care be dependent on reaching a website when reliable access to the internet might be 20 miles or more away?
Setting up a work requirement and a website isn't an accurate enough assessment of people's circumstances, so a state government interested in a realistic picture of what's going on would take greater steps to make sure required reporting could be done easily.
Should mailing in a postcard be an option? Should there be some kind of phone number people can call?
For every undeserving person booted off this program designed to help Arkansans in need, we commend the state. But state government also owes it to its citizens to be darn sure people in need aren't being swept off the Arkansas Works rolls by state-sponsored electronic hurdles some residents can't overcome.
Commentary on 10/17/2018