Three Arkansans have filed suit in U.S. District Court against the new work requirements associated with the Arkansas Works Medicaid expansion program.
The suit says the federal executive branch bypassed the legislative process and acted on its own to “comprehensively transform” Medicaid.
“Purporting to invoke a narrow statutory waiver authority that allows experimental projects ‘likely to assist in promoting the objectives’ of Medicaid, the Executive Branch has instead effectively rewritten the statute, ignoring congressional restrictions, overturning a half century of administrative practice, and threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country,” the suit says.
Under the terms of the waiver granted to Arkansas by the Department of Health and Human Services, Arkansas Works enrollees ages 19 to 49 must work 80 hours per month, engage in job training or educational activities, or do community service work. Those who fail to comply for three months in a calendar year can lose their health insurance. Various individuals, such as pregnant women, are exempt. Arkansas began implementing the work requirement June 1 for recipients ages 30-49 and will expand that requirement to individuals ages 19 to 29 during the first part of next year.
Arkansas Works is the state program that expanded the Medicaid population to individuals earning up to 138 percent of the federal poverty level under the Affordable Care Act, otherwise known as Obamacare. Medicaid is the federal-state partnership that provides health services to poor people and others. Instead of using the money to simply expand Medicaid, Arkansas obtained a waiver in 2014 to to use mostly federal dollars to purchase private health insurance for eligible individuals. The Trump administration approved the waiver March 5.
The plaintiffs are Charles Gresham, 37, of Harrison; Cesar Ardon, 40, of Siloam Springs; and Marisol Ardon, 44, of Siloam Springs. They say the waiver exceeded the administration’s authority and “will harm Arkansans across the state who need a range of health services.”
They filed suit against Health and Human Services Secretary Alex Azar and his department, and the Centers for Medicare and Medicaid Services and its administrator, Seema Verna.
On Tuesday, the state Department of Human Services (DHS) reported that 265,223 individuals were served by Arkansas Works as of Aug. 1 – down from 285,564 in January.
Of the 270,676 Arkansans served by Arkansas Works on July 1, 46,025 were originally estimated to be subject to the work requirement in July.
Of that group, 30,228 were meeting the requirement and are not required to report. Another 844 satisfied the reporting requirement, while 1,571 reported an exemption since they had received the notice. Another 12,722 did not satisfy the reporting requirement.
DHS said that 5,426 individuals had not complied with the requirement for two months, leaving them one month short of losing their health insurance. Another 6,531 had not complied for one month.
Recipients must report their work activities through an online portal, which the suit calls “a difficult, if not impossible task for Plaintiffs on a regular basis due to lack of internet access, trouble using computers, and problems working with the online portal.”
On Tuesday, DHS announced it was expanding its call center hours so that they are open from 7 a.m. until 9 p.m. seven days a week.
The suit says Gresham is not working at this time because he suffers from a seizure disorder along with extreme social anxiety and asthma. He did not meet the work requirements in June and July and also cannot meet other requirements because he lacks transportation and is uncomfortable with computers. Losing his medications would cause his seizures to worsen.
Cesar Ardon is a self-employed handyman who previously worked as a welder for 15 years until having surgery to remove a tumor. He met the work requirement in July after failing to meet it in June, but he is uncomfortable using the online portal, the suit says.
Marisol Ardon is Ardon’s husband, but they are separated, though they live in the same house with separate entrances. She has several medical conditions and has not worked since March 2017.
Gov. Asa Hutchinson released a statement Tuesday saying, “This lawsuit has one goal, which is to undermine our efforts to bring Arkansans back into the workforce, increase worker training, and to offer improved economic prospects for those who desire to be less dependent on the government.
“As for the process of reporting work, DHS is providing substantial assistance to anyone that has limited access to internet or who may encounter additional challenges. Our goal is to assist those in compliance so that their healthcare coverage continues; however, we must have an accountable system that does not leave thousands of able-bodied recipients on the Medicaid rolls who may not qualify for a whole host of reasons.”
The plaintiffs are represented by the National Health Law Program, Legal Aid of Arkansas, and the Southern Poverty Law Center.
In a tweet Tuesday, the Southern Poverty Law Center said, “The approval will lead to thousands of low-income individuals and families losing access to vital health care. We’re suing.”
On its Facebook page, Legal Aid of Arkansas said, “Big news! The Arkansas Works work requirements and online-only reporting system are administrative hoops likely to lead to the loss of health insurance for thousands of low-income Arkansans, including many people who are working, disabled, or caring for a family member. Because of the harm to our clients, Legal Aid of Arkansas has filed a lawsuit in federal court to challenge the work requirements.”
Hutchinson criticized those groups – particularly Legal Aid, saying, “This lawsuit comes as no surprise. It is particularly disappointing, though, when you consider that the group making the challenge is, in part, funded by federal taxpayer dollars. They have a consistent history of trying to thwart any effort to transform and bring accountability to our Medicaid program.”