Two Arkansans who temporarily lost their Arkansas Works health coverage due to the program's work requirement and four other program enrollees were added Monday as plaintiffs to a federal lawsuit challenging the provision.
Adrian McGonigal, 40, of Pea Ridge and Jamie Deyo, 38, of Lonoke are among more than 8,400 people who have lost their Arkansas Works coverage since the requirement to spend 80 hours a month on work or other approved activities took effect in June.
An additional 4,841 enrollees had accumulated two months of noncompliance as of Oct. 8 and were set to lose coverage last week unless they met the requirement for October.
The additions bring the number of enrollees listed as plaintiffs in the Aug. 14 suit to nine.
Filed in Washington, D.C., by the National Health Law Program, the Southern Poverty Law Center and Jonesboro-based Legal Aid of Arkansas, the suit contends that President Donald Trump's administration exceeded its authority when it approved the Arkansas requirement in March.
The suit also takes issue with a requirement that Arkansas enrollees use a state website to report whether they worked the required number of hours or qualified for an exemption. The lawsuit notes that the 2010 Patient Protection and Affordable Care Act requires states to allow enrollees to submit eligibility forms online, in person, by mail or by telephone.
Gov. Asa Hutchinson said in a statement last month that those who lost their coverage "have either found work, moved onto other insurance, moved out of state without notifying [the Department of Human Services], or chose not to comply.
"We have gone to great lengths to ensure that those who qualify for the program keep their coverage," he said.
Arkansas Works covers people who became eligible for Medicaid when the state extended eligibility in 2014 to adults with incomes of up to 138 percent of the poverty level.
The income cutoff this year, for instance, is $16,753 for an individual or $34,638 for a family of four.
Most enrollees receive the coverage through private plans, with the Medicaid program paying most or all of the premium.
The work requirement was phased in this year for enrollees age 30-49 and will apply next year to those age 19-29.
Enrollees who fail to meet the work requirement for three months during a year are terminated from the program and barred from re-enrolling for the rest of the year.
Both McGonigal and Deyo learned they had lost their coverage when they went to a pharmacy to fill a prescription, according to Monday's filing adding the new plaintiffs.
With the help of his family, McGonigal had used the website to report his work activities in June, but didn't know he had to make the reports every month, attorneys for the plaintiffs wrote in the filing.
Unable to afford the more than $800 cost out of his pocket for his drugs for chronic obstructive pulmonary disease and other ailments, he ended up leaving the pharmacy empty-handed after discovering on Oct. 5 that his coverage had been canceled, the attorneys wrote.
He then ended up going to the emergency room for treatment, missed several days of work at his job at a poultry company and was fired due to the absences, the attorneys wrote.
While he was without coverage, McGonigal was hospitalized twice for breathing treatments, has been able to sleep only two or three hours a night and has endured more pain from his degenerative disc disease, the attorneys wrote.
He is now in the process of getting his coverage restored after the department granted him a "good cause" exemption from the work requirement due to his lack of a permanent address and extenuating health circumstances, the attorneys wrote.
But with no job, he is unsure how he'll meet the work and reporting requirements in the future, the filing says.
Deyo also left the pharmacy without her medications after learning on Sept. 17 that her coverage had been canceled, the attorneys wrote.
She had moved within the previous year and hadn't received any notices about the requirement, the attorneys wrote. Although she had informed her insurance company, St. Louis-based Centene, about the address change, she believes the company "did not transmit her address change to DHS," the attorneys wrote.
Without coverage, Deyo, whose back was seriously injured in a 2013 car accident, delayed filling prescriptions, missed an appointment with a surgeon and was charged out of pocket for a physical therapy visit, the attorneys wrote.
Because she hadn't been notified of the work requirement, the Human Services Department granted her an exemption and reinstated her coverage on Thursday, the attorneys wrote.
The other plaintiffs added Monday are Anna Book, 38, and Russell Cook, 26, both of Little Rock, Treda Robinson, 42, of Searcy, and Veronica Watson, 36, of Moro.
Book, who works as a dishwasher and was homeless for most of the past eight years, visits her church each month to report her hours with the help of her pastor, the attorneys wrote. She was out of compliance with the requirement in July, when she got her job, and is afraid of losing her coverage if she loses her job or doesn't have enough hours to meet the requirement, the attorneys wrote.
Cook, who is homeless and unemployed, doesn't think he'll be able to meet the requirement when it applies to him next year, the attorneys wrote.
Watson, who started work at a shirt factory in late August, doesn't have a home computer or Internet access and wasn't able to use the state website in August, when she was found out of compliance with the work requirement, the attorneys wrote. The nearest library or Human Services Department where she can access a computer is a 40-mile round trip from her home, the attorneys wrote.
Robinson, who became subject to the work requirement in September, qualified for an exemption for September and October after undergoing surgery to remove tumors. That exemption expired Oct. 31, and she worries she won't have enough hours from her job as a scoring assessment rater for the Educational Testing Service to keep her coverage, the attorneys wrote.
She works from home and has iron deficiency anemia that often leaves her too weak to leave home, the attorneys wrote.
The National Health Law Program and Southern Poverty Law Center also filed a lawsuit challenging a work requirement in Kentucky.
U.S. District Judge James Boasberg, who is presiding over the Arkansas case, on June 29 blocked Kentucky from implementing its requirement, saying U.S. Health and Human Services Secretary Alex Azar didn't adequately consider the effect it would have on residents' health coverage.
Metro on 11/06/2018