The state is removing 4,353 individuals from the Arkansas Works health insurance program for failing to report they were complying with its work requirement, although Gov. Asa Hutchinson said Wednesday that some individuals may have obtained health insurance elsewhere or moved out of state.
His Democratic opponent, Jared Henderson, suggested that the online reporting system was either poorly designed or purposely meant to reduce the rolls.
The 4,353 individuals failed to report they were complying with the program’s work requirement during the three months it has been in effect. Under the requirement, beneficiaries who fail to comply for three months in a calendar year lose coverage. They will not be able to regain it until Jan. 1.
Hutchinson said the state pays $570 in insurance premiums per month for each individual receiving Arkansas Works benefits. Reducing the rolls by 4,353 will save the state $30 million a year.
But Hutchinson said the requirement is not being driven by budget concerns, and there is no target number for reducing the number of individuals served by using the work requirement. Instead, he said the goal is to increase labor participation and provide assistance to able-bodied people who want to work.
“Nothing is punitive,” he said. “That’s not the design of this to be punitive. The design is to balance values, and the values are compassion, which I believe I fought for very hard with Arkansas Works. It’s providing assistance to those that are trying to help themselves. It’s also about the value of work is important and the value of responsibility. I think this achieves a good balance there, and we’re working very hard to make it work right.”
Prior to Hutchinson’s press conference, his Democratic opponent, Henderson, criticized the work requirement, saying that having health insurance through Medicaid does not provide a disincentive to work. He said the program is “either stunningly bad poorly designed, or it’s meant to kick people off.”
“We have literally created a new bureaucracy between some of our most struggling citizens and one of their most basic needs, and we’re not only harming them and their families, we’re putting strains on our hospitals, on our health care community, and on our broader communities at large,” he said.
Originally known as the “private option,” Arkansas Works was created by Republican legislators and Gov. Mike Beebe in 2013 after the U.S. Supreme Court ruled states could choose whether or not to expand their Medicaid populations under the Affordable Care Act, otherwise known as Obamacare. Many Republican-leaning states chose not to expand their populations. Arkansas did, but instead of simply expanding Medicaid, it used mostly federal funds to purchase private health insurance for those lower-income individuals.
At the beginning of August, the program covered 265,223 individuals, down from 285,564 on Jan. 1.
Earlier this year, Gov. Asa Hutchinson’s administration obtained a waiver from the federal government allowing it to require some recipients to work. 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. 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.
As of July 8, about 62,000 recipients were subject to the work requirement in August, but only 22,445 were required to report their work or community engagement activities. By Sept. 9, the number of recipients required to report their activities had dropped to 60,012.
DHS reported that 40,190 were meeting the requirement and are exempt from having to report their activities. Among those were 19,391 who were employed at least 80 hours per month. Another 16,357 did not satisfy the reporting requirement, while 2,247 reported an exemption since receiving notice they had to comply, and 1,218 satisfied the reporting requirement.
Hutchinson said one woman in Harrison learned of the work requirement through the mail, got help from the Department of Workforce Services, and enrolled in nursing school. A man who had been out of work for nine months found a job and now earns $17.64 an hour. One person in Searcy who was worried about losing health insurance came to a DWS center and got a job making $9 an hour and working 30 hours a week.
In addition to the 4,353 individuals whose cases have been closed, 5,076 have failed to comply for a total two months and 6,174 have failed to comply for one month, according to DHS.
Arkansas Works recipients are required to report their activities online, though they can contact one of more than 200 registered reporters who can help them complete the process. Recipients can get help at a DHS county office.
The state made a variety of efforts to contact recipients about the need to report their work activities, including mailing 59,803 letters and making 150,213 phone calls.
Henderson said some Arkansans do not have good access to the internet, making it hard to comply with the work requirement.
Dr. Tonya Martin-Dunlap, a breast cancer surgeon based in Little Rock, said during Henderson’s press conference that when the state first expanded Medicaid, “a good number of women and a couple of men” presented themselves to her with advanced cancers they had known about but had not addressed because they lacked health insurance. By waiting, they increased the cost of their care and decreased their chances of survival.
In the past couple of months, one of her cancer patients lost Medicaid coverage. She said she does provide free care, but in order to serve a patient she must also convince numerous other providers to also donate.
Department of Human Services Director Cindy Gillespie said the state has more than 100 community health centers that can serve uninsured patients. She said that particular patient can perhaps obtain a good cause exemption. Of 55 good cause requests completed in August, 45 were granted.
“If they just didn’t do anything and they were able-bodied and able to work or engage in the community in some way, and they chose not to, that is not a good cause exemption,” she said.