Arkansas Works numbers show 1.8% rise

The number of people served by the state’s Arkansas Works program increased by 4,215 from March 1 to April 1.

The state’s Department of Human Services reported Monday (April 15) that the population April 1 was 240,177, compared to 235,962 on March 1. The difference represents a 1.8% increase from the March 1 total.

The April 1 total was the highest beginning-of-the-month total this year. On Jan. 1, it was 234,400.

Including Arkansas Works, a total of 894,247 Arkansans were served by the Medicaid program April 1. That amount was 11,870 more, or 1.3%, than were served on March 1, when the total was 882,377.

Of the April 1 amount, 237,859 adults were enrolled in traditional Medicaid, while 416,211 were enrolled in the the Children’s Health Insurance Program. CHIP provides health insurance coverage to children in families earning too high an income to qualify for Medicaid.

Enrollment in Arkansas Works on the last day of March was 247,631, after it was 245,198 on Feb. 28. Total Medicaid enrollment on March 31 was 912,377, while it was 903,776 on Feb. 28.

Medicaid coverage numbers are higher at the end of each month because recipients are covered one a month at a time. Closures caused by factors such as increased income occur at the end of the month.

DHS has not analyzed why the numbers have increased, said Marci Manley, DHS deputy chief of communications.

“The increases in both (Arkansas Works) and traditional Medicaid seem at this point statistically insignificant,” said Ray Hanley, president and chief executive officer of Arkansas Foundation for Medical Care, in an email. The nonprofit organization assists beneficiaries and health care providers in improving health care access and reducing costs.

This is the first month this year that the DHS report did not include data on Arkansas Works recipients who have failed to meet a work requirement that was struck down March 27 by a U.S. district judge.

Judge James Boasberg ruled that the decision to grant Arkansas the work requirement waiver was “arbitrary and capricious because it did not address – despite receiving substantial comments on the matter – whether and how the project would implicate the ‘core’ objective of Medicaid: the provision of medical coverage to the needy.”

He ruled in the Arkansas case and in a separate Kentucky case that the work requirement could not stand. He relied on an earlier ruling against Kentucky’s work requirement he had made in June 2018.

More than 13,000 recipients of the state’s Arkansas Works program did not meet its work requirement in February.

President Trump’s administration has filed a notice of appeal with the D.C. Circuit Court of Appeals. Arkansas Attorney General Leslie Rutledge has also filed a notice that the state will make its own appeal.

Originally known as the “private option,” Arkansas Works was created by legislators and Gov. Mike Beebe’s administration in 2013. It was created 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.

After Gov. Asa Hutchinson was elected, he embraced the program, helping it each year attain the 75% support required in both the Arkansas House and Senate to fund the division that administers the program. To help secure that support among skeptical lawmakers, the state requested and was granted a federal waiver allowing it to require non-exempt recipients to work 80 hours per month or engage in other community engagement activities.

That waiver was struck down March 27, but the Arkansas Legislature funded the division.

Hanley, whose AFMC had contacted participants about the work requirement as part of a state contract, said of the program, “The U.S. has seen 95 rural hospitals close in the past eight years, mostly in the (Southeast) where Medicaid wasn’t expanded. Arkansas has seen none close, and AW has been a major reason for being able to keep the doors open.”

In 2018, 18,164 enrollees lost coverage for failing to meet the requirement. Of those, 2,781 have regained coverage in 2019 – 2,741 of them in Arkansas Works, Manley said.

According to the Department of Workforce Services, a total of 12,477 participants found employment through the program from June 1, 2018 until April 4, 2019.