Medicaid rule meant to aid, Arkansas governor says

Moving people into jobs cited as goal

In this file photo Arkansas Human Services Director Cindy Gillespie talks about the people who lost health coverage under Arkansas Works because they failed to comply with the program’s new work requirement conditions. Gov. Asa Hutchinson (center) and Workforce Services Director Daryl Bassett also spoke.
In this file photo Arkansas Human Services Director Cindy Gillespie talks about the people who lost health coverage under Arkansas Works because they failed to comply with the program’s new work requirement conditions. Gov. Asa Hutchinson (center) and Workforce Services Director Daryl Bassett also spoke.

Gov. Asa Hutchinson said Wednesday that he would like to see fewer people lose their Arkansas Works health coverage, and more of them move into jobs, as a result of the program's work requirement.

But he insisted the requirement is not meant to be punitive. Instead, he said, it is designed to "balance values," which he listed as compassion, helping those "who are trying to help themselves," work and responsibility.

"We've gone in our state generation after generation with some having generational poverty -- not having the work skills they need," Hutchinson said. "This is an opportunity to help provide that assistance."

At a news conference earlier in the day, Jared Henderson, Hutchinson's Democratic opponent in the Nov. 6 election, said the work requirement, under which enrollees must use a state website to report their work hours or exemption status, is hurting patients and health care providers.

"We have become the first state in the country to impose an Internet requirement, to create a new bureaucracy between some of our most vulnerable citizens and their access to health insurance," he said.

According to Arkansas Department of Human Services figures released Wednesday, 4,353 people whose coverage was terminated Sept. 1 for failing to comply with the work requirement remained without coverage as of Sunday.

Meanwhile, an additional 5,076 beneficiaries had accumulated two months of noncompliance and will lose coverage at the end of this month unless they report work hours or exemptions for September.

Hutchinson said that some who lost coverage may have found other coverage or moved out of the state, while others "simply don't want to be a part of the workforce."

He noted that, using mostly federal funds, the state pays $570 a month in premiums and other payments to insurance companies for each enrollee. The reduction in enrollment lowers the total amount of those payments by about $30 million a year.

"I think it would be the common sense judgment of the people of Arkansas that we should not continue to pay" that cost, Hutchinson said.

Arkansas is one of four states that received federal approval to impose a work requirement on some of its Medicaid enrollees, and in June it became the first -- and so far the only -- state to implement one.

The requirement is being phased in this year for participants ages 30-49 and next year for those ages 19-29. When fully implemented, the requirement is expected to apply to more than half of the people on Arkansas Works, as the expanded part of the state's Medicaid program is called.

To meet the requirement, enrollees must spend 80 hours a month on work or other approved activities unless they qualify for an exemption. Those who fail to comply for three months during a year are moved off the program and barred from re-enrolling for the rest of the year.

Terminations as a result of the work requirement were one reason Arkansas Works enrollment from Aug. 1 to Sept. 1 fell by more than 6,700 people to 258,519, according to figures released Wednesday.

Those who lost coverage Sept. 1 were among the first 26,000 enrollees who became subject to the work requirement on June 1.

Enrollees who failed to meet the requirement in June, July and August lost their coverage Sept. 1. They could then have their coverage restored if they reported their hours or exemptions for August by Sept. 5, but that deadline was extended to Oct. 5 for those who had problems accessing the website,, because of a computer problem that affected several state agencies.

Although the exact number of enrollees who lost coverage Sept. 1 wasn't available Wednesday, the department indicated last week that it was at least 4,574.

That was how many people had lost coverage and still had not reported hours or an exemption for August as of Sept. 3.

The figures released Wednesday indicated that 221 people who lost coverage Sept. 1 had their coverage restored as of Sunday.

Of the 60,012 enrollees who were subject to the work requirement in August, 16,357 failed to comply.

Among those in compliance, 40,190 were not required to report their work hours because information in state records indicated that they qualified for an exemption or had incomes high enough that they were likely working the required amount of hours.

Just 3,465 met the requirement by reporting their work hours or an exemption through the website.

Kevin De Liban, an attorney with Jonesboro-based Legal Aid of Arkansas, said many of those who didn't report their hours or an exemption likely did so because of a lack of Internet access or knowledge about the requirement.

He is among the attorneys representing Arkansas Works enrollees in a federal lawsuit in Washington, D.C., that contends the requirement violates the laws governing Medicaid.

"Thousands of people who likely met the work requirement or an exemption are getting kicked off wrongly," he said.

Hutchinson said the state has tried to make sure enrollees know about the requirement and can get help using the site.

Workers at the Human Services Department's county offices can provide one-on-one help using the site, and the three insurance companies that offer Arkansas Works plans have employees who are authorized to access the site on behalf of enrollees to report work hours or exemptions, he noted.

Enrollees can also authorize other people to make the reports on their behalf.

While the work requirement caused some enrollees to lose coverage, Hutchinson said, it also has led some to seek help from the state Department of Workforce Services. He cited the example of a man in Rogers who found a job paying $17.64 an hour; a woman in Harrison who enrolled in nursing classes, with an assistance program covering her tuition, and who works one day a week at a long-term care facility; and a Searcy woman who is exempt from the work requirement because she has a child in her home but nevertheless found a job at a behavioral health center where she works 30 hours a week.

Since June 1, at least 1,159 enrollees who were subject to the requirement have started new jobs, said Steve Guntharp, a spokesman for the Workforce Services Department.

Cissy Clark, owner of Clark's Family Pharmacy in Earle, said she's helped three or four of her customers who are on Arkansas Works enter their information on the state website and found out they qualified for an exemption.

"They need to open their mail. That would be my biggest encouragement to them," she said. "I've had a few that were like, 'I didn't know anything about it.'"

She hadn't yet heard from customers who lost coverage because of the requirement, but she expects to as it is extended to more enrollees.

About 30 percent of her customers are covered by Arkansas Works, and many don't have access to computers or the Internet, she said.

"I'm worried about their health, because they'll do without" if their coverage gets cut off, she said.

The lawsuit challenging the requirement has been assigned to U.S. District Judge James Boasberg, who in June stopped a work requirement from taking effect in Kentucky.

Boasberg on Wednesday denied a request by attorneys for President Donald Trump's administration to have the case assigned to a different judge.

Attorneys with the U.S. Department of Justice had argued that the Arkansas case shouldn't be designated as being related to the Kentucky case because federal officials issued separate approvals for the requirements in each of the states.

A docket entry describing the ruling said the cases' "common factual and legal issues, many of which are quite complex, militate in favor of this Court retaining the new case in the interest of judicial economy."

A Section on 09/13/2018

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