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Recent national and local press coverage paints an unfair and incomplete picture of the new Arkansas Medicaid work and community engagement program.

Under this program, some Arkansas Medicaid expansion clients now have an 80-hour per month obligation to work, look for work, get job training, go to school, or volunteer. In exchange, clients receive access to state-subsidized affordable health insurance.

Much of the criticism focuses on the 12,277 clients who have not reported their work or community engagement hours for three months, causing them to lose health insurance for the rest of the year.

While much has been said about the loss of insurance, less attention has been paid to the state's efforts to help clients meet the new requirements.

Arkansas contracted with a nonprofit health-improvement organization, AFMC, to hire and train representatives who reach out to Arkansas Works clients. Representatives provide step-by-step information necessary to comply with the work and community engagement requirements. These requirements currently apply only to people ages 30-49, initially estimated to be 99,000 clients. Of these, DHS expected 60,000 would be exempt from the reporting requirements, leaving 39,000 clients with ongoing reporting obligations.

Operating 14 hours a day, seven days a week, AFMC has placed over 153,000 educational calls to Arkansas Works clients. In addition to repeated phone calls, the Arkansas Department of Human Services sent multiple letters, emails and text messages. The Department of Human Services and Arkansas Workforce Services Agency staff are also available to assist clients.

AFMC could not reach more than 13,300 clients who did not provide current accurate contact information. Some may have moved out of state. During the three months that these clients did not make reports, the state continued to pay an average of $570 per month for each individual's health insurance subsidy.

Public assistance work requirements are not novel, unique or hard to meet. Of the three major federal welfare programs, only Medicaid lacks a work requirement. The Arkansas Works requirements are modeled after the time-tested and well accepted work requirements under Temporary Assistance for Needy Families (TANF, formerly called AFDC) and the Special Nutrition Assistance Program (SNAP, formerly called food stamps).

Contrary to news accounts, clients are not left on their own to accomplish these modest requirements. Human Services and Workforce Services employees help clients with the reporting process. Clients can report their work/community engagement hours using a smartphone, tablet or computer, or they may use a computer at one of 335 county Department of Human Services and Workforce Services offices and public libraries around the state. Clients can call the Access Arkansas toll-free number for assistance and be transferred to their insurance carrier, who can complete the reporting requirements for them.

Help is there for the asking, and compliance is possible without ever touching a computer.

Arkansans support helping able-bodied adults find jobs and concentrating limited Medicaid program resources on those who need it most. Gov. Asa Hutchinson and the Department of Human Services have worked hard to make compliance easily achievable.

This program is a serious attempt to connect Arkansas Works clients with opportunities that improve their lives and serve as a path out of poverty.


Ray Hanley is the AFMC president and CEO. He has worked on improving access and the quality of health care for over 40 years, including helping clients as a caseworker and as Arkansas Medicaid director for 16 years.

Editorial on 12/06/2018

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  • drs01
    December 6, 2018 at 8:57 a.m.

    I hope those who demonize this work requirement will read this op-ed. The work requirement applies to able bodied individuals, as quoted here: "These requirements currently apply only to people ages 30-49".

  • GeneralMac
    December 6, 2018 at 11:14 a.m.

    "usual suspects" are no where to be found replying to this informative article.