NWA EDITORIAL: Be sure, Arkansas

Health insurance too precious for poor Arkansans

Should be at least as important to the state that they don't kick off someone who needs coverage and is qualified as saving the money from people dropping off the rolls as a money-saving measure.

Thursday, we learned another 3,800 Arkansans who previously had health insurance through Arkansas Works have been kicked out of the program as a result of the state's work requirement. That brings the total since the requirement went into effect on June 1 to 12,277.

What’s the point?

Arkansas still has a ways to go before it can celebrate the elimination of Medicaid expansion insurance coverage for more than 12,000 people.

From a budgetary standpoint, that's something to celebrate, right? Every time an Arkansas Works recipient gets kicked off the program, the state saves money. Arkansas Works is the state's current version of the Medicaid expansion that happened under the Affordable Care Act, or Obamacare.

It's amazing the Medicaid expansion even survived in Arkansas, but once a Republican governor took the helm, it got easier to keep around. Why? Because it made sense. Arkansas Works -- known in its previous iteration as the "private option" -- has been credited with helping hospitals, especially smaller ones serving rural areas, recover financially. When the people covered by Arkansas Works -- now 245,553 of them -- didn't have any health coverage, hospitals faced heavy financial burdens from providing care for them. The new system of subsidized private health insurance shored up the health care delivery system. And that, friends, has served a lot more Arkansans. Closed hospitals serve no one.

Gov. Asa Hutchinson, though, pushed for and got a waiver from the federal government so the state could require recipients of the health insurance to jump through a bunch of hoops to prove they're either looking for work or working. Then the state created a reporting system that is viewed skeptically by critics.

Do you have confidence our state government has found 12,277 people who were bilking the system, or is it reasonable to suspect some qualifying Arkansans lost coverage because the state decided, on one hand, to provide expanded Medicaid coverage then, on the other hand, to work hard to put it out of reach for Arkansans who need it.

It's not just editorial writers who are concerned. Advocates for families say the state's system is flawed and is hurting those in need, including children. And last week, a federal advisory group urged U.S. Health and Human Services Secretary Alex Azar to temporarily halt enforcement of the work requirement. The sheer volume of people being cut from the program is enough to raise concerns about whether it's working the way it was intended, the commission advised.

We don't know anyone who argues to give unqualified people health coverage through Arkansas works. It is the state's system that is suspect. And while the huge number of people cut from the rolls means budgetary savings, it can hardly be evaluated on that basis alone.

We hear from Republicans often that voter identification and other voting changes are vital to make sure not a single illicit vote is cast. Shouldn't the state apply the same standard, except in reverse, to its effort to make health insurance available to poor people who cannot afford it any other way? Let's make sure not a single qualifying individual or family is being tossed aside simply because of governmental regulatory barriers.

The state has more work to do to develop a trustworthy system that ensures no qualifying person gets booted out of the program.

The work requirement was about the politics necessary to get the program passed. Fair enough. But Gov. Hutchinson and lawmakers need to make sure Arkansas Works is delivered to those who need it. That's why it was created in the first place.

If Arkansas Works is the dog, the work requirement is the tail, and it seems right now the tail is busy wagging that dog.

Has Arkansas aggressively sought to educate the poor people on Arkansas Works? They've done significant work, but the process is still suspect, and thousands being cut from the program is not evidence in itself that a bunch of freeloaders are being run off.

We'd recommend the benefit of the doubt should go with Arkansas Works enrollees because coverage for qualified individuals is, all in all, good for Arkansas.

Commentary on 11/17/2018

Upcoming Events