More than 4,600 Arkansas Works enrollees lost their health insurance this month for failing to comply with the program's work requirement, making it the worst month for coverage losses since the state began phasing in the requirement in June, according to figures released Monday.
The terminations bring the total number who have lost coverage because of the requirement to 16,932.
That's about 44 percent of the 38,000 enrollees the state initially estimated would be subject to the work requirement this year and not automatically exempt based on information in state records.
Meanwhile, an additional 1,936 enrollees had accumulated two months of noncompliance as of Dec. 7. They will lose coverage Jan. 1 unless they comply with the requirement this month, although they will be able to reapply immediately with a clean compliance record for 2019.
To meet the requirement, enrollees who don't qualify for an exemption must spend 80 hours a month on work or other approved activities and report the hours using a state website. Starting Wednesday, they will also be able to call a Department of Human Services call center at (855) 372-1084 to report over the phone.
Enrollees who fail to meet the requirement for three months during a year are terminated from the program and barred from re-enrolling for the rest of the year.
Gov. Asa Hutchinson noted in a statement that more than 4,100 enrollees subject to the requirement have started new jobs, which he said is a sign the "program is accomplishing its intent."
Steve Guntharp, assistant director of the state Department of Workforce Services, said officials don't know how many of the 4,170 enrollees subject to the work requirement who have started new jobs since June 1 were previously unemployed, rather than moving from one job to another.
Hutchinson also noted that the percentage of enrollees subject to the work requirement who were in compliance -- either by reporting through the website or through an automatic exemption -- has increased from 73 percent in August to 87 percent in November.
"This is a strong indication that more and more people are learning about the requirement and following through with their reporting," he said.
Some of the improvement is also due to the removal of noncompliant enrollees.
From August to November, the percentage of enrollees who had either been already removed from the program or who were out of compliance fell only slightly, from 27.3 percent to 26.9 percent.
Partly as a result of the terminations, the state also reported that total enrollment in the program dropped from Nov. 1 to Dec 1. by more than 11,000, to 234,385.
Hutchinson said the drop was due to efforts to verify the eligibility of enrollees as well as to a low unemployment rate and a reduction in the number of Arkansans who are in poverty.
"These statistics support my belief that many of these individuals have moved into work and up the economic ladder," Hutchinson said.
As for the 4,655 enrollees who lost coverage, "they will have an opportunity to re-enroll in January," Hutchinson said.
State Democratic Party Chairman Michael John Gray called the work requirement a failure.
"The experiment is over, and the results are disastrous," Gray said in a statement.
Party spokesman Jacob Kauffman said Gray is calling for the end of the requirement "as it exists currently."
"If Arkansas is to have a work requirement, it must ensure that qualified, working people are not kicked off of their health insurance coverage for failing to navigate arbitrary and arcane reporting systems," Kauffman said in an email.
The requirement is the first to be implemented for a state Medicaid program. In June, a federal judge in Washington, D.C., stopped a similar requirement from taking effect in Kentucky the following month, saying President Donald Trump's administration hadn't considered how the requirement would affect the Medicaid program's goal of providing health coverage to low-income people.
The same judge is presiding over a lawsuit challenging Arkansas' requirement on the same grounds.
Jamie Deyo, one of the plaintiffs in the Arkansas case, said in a phone interview Monday that she hadn't heard of the work requirement until September, when she went to the pharmacy and discovered her coverage had been canceled.
"I literally freaked out," Deyo said. "I called a disability attorney and cried."
Deyo, 38, said she's unemployed because of a back injury that makes it difficult to stand for long periods of time. She didn't even know she had a Medicaid plan, she said. Like most enrollees, she had received her coverage through a private plan, with the premium paid by Medicaid.
She signed up for a plan offered by St. Louis-based Centene last year while she was in a substance abuse treatment program and using her grandparents' house in North Little Rock as her mailing address. She then moved to her parents' house in Lonoke. She said she told the company about the address change, but the information apparently didn't reach the Human Services Department.
In light of the mix-up, the department restored her eligibility, first putting her on the traditional, fee-for-service Medicaid program in October while she waited for her coverage under the Centene plan to start last month.
In the meantime, she had to cancel an appointment with a back surgeon and missed her sessions with a physical therapist and counselor. Her parents paid out of pocket to fill her prescriptions.
After she tried unsuccessfully to use the state website, access.arkansas.gov, at her parents' house, an attorney with Jonesboro-based Legal Aid of Arkansas helped her apply for an exemption from the requirement because of a short-term disability.
After having surgery on her back, she said, she hopes to take classes to work in medical billing -- a plan that the coverage loss delayed by months.
"I don't think Trump or whoever it is really knows that damage that it does to people, especially when they don't have health insurance and really need it," she said.
Arkansas Works covers Arkansans who became eligible for Medicaid when the state extended the assistance in 2014 to adults with incomes of up to 138 percent of the poverty level.
The work requirement was phased in this year for enrollees ages 30-49. Next month, it will start for an initial group of about 13,600 enrollees ages 19-29, state Department of Human Services spokesman Marci Manley said.
When the requirement is fully phased in over the following months, a total of about 88,000 enrollees in that age group will be subject to the requirement, she said.
Of the 64,743 enrollees who were subject to the requirement in November, 54,882 were exempt based on information in state records, including 907 who were deemed in compliance because they were meeting the food stamp program's work requirement.
Only 1,435 enrollees met the requirement by using the state website. That comprised 914 who reported an exemption and 521 who reported the required number of hours or other approved activities, such as volunteering or looking for a job.
Of the 8,426 enrollees who failed to comply, 118 reported some hours through the website, but not enough to meet the requirement.
Manley said the department will investigate the reasons for noncompliance as part of an evaluation that it will commission. The department is also considering conducting focus groups with current and former enrollees to explore the issue, she said.
"We want to see people succeed," she said. "We'd like to see that number who have three months of not meeting the requirement be zero each month."
A Section on 12/18/2018