More than 53,000 in state lose Medicaid coverage in September

In this file photo, Kristi Putnam, Secretary of the Department of Human Services, presents an update on the American Rescue Plan Act funds for hospitals during a meeting of the Joint Committees on Public Health, Welfare, and Labor at the State Capitol on Tuesday, June 20, 2023...(Arkansas Democrat-Gazette/Stephen Swofford)

More than 53,000 Arkansans lost Medicaid coverage in September because they either didn’t return information needed to determine their eligibility or were no longer eligible, the Arkansas Department of Human Services reported Monday.

The Arkansans include 18,545 whose coverage had been extended previously because of special eligibility rules during the federal covid-19 public health emergency, and 35,008 others whose coverage was discontinued as part of normal operations, according to the department.

The state Department of Human Services said Monday it has successfully completed eligibility redeterminations on Medicaid beneficiaries whose coverage was extended due to special rules that has been in effect during the federal government’s covid-19 public health emergency.

The continuous enrollment requirement during the federal public health emergency prevented the state Department of Human Services from removing most ineligible individuals from Medicaid, but normal eligibility rules resumed April 1, the department said. During the past six months, the department said it worked to reevaluate eligibility based on these normal eligibility rules, which are set by Congress and the U.S. Centers for Medicare and Medicaid Services.

In contrast, the state Department of Human Services said the department would disenroll about 20,000 to 30,000 ineligible individuals a month on normal eligibility rules.

Besides those who were disenrolled in September, 45,536 Medicaid beneficiaries had their coverage renewed in September after their eligibility was confirmed under normal eligibility rules, the department said.

“Medicaid resources should go to Arkansans who qualify for them, and not for those who are ineligible,” state Department of Human Services Secretary Kristi Putnam said in the department’s news release.

“I’m proud of the work that staff across our entire agency performed over the last six months to ensure that our program is serving only those who truly need Medicaid,” she said. “And I’m excited to finally put the pandemic and the special rules that had been in place behind us so we can focus on serving Arkansans under normal eligibility operations going forward.”

Some critics of the department counter that too many children in Arkansas have been removed from the Medicaid program’s rolls during the past six months.

State Department of Human Services spokesman Gavin Lesnick said Monday the state’s total Medicaid enrollment as of Oct. 1, including the number of adults on the state’s Medicaid expansion program, the number of other adults enrolled in the Medicaid program and the number children enrolled in the Medicaid program, “are still pending.”

He said he expect the figures to be available sometime this week, possibly Tuesday.

As of Sept. 1, the state’s Medicaid enrollment totaled 877,544, the department reported last month. That’s compared with a total enrollment of 1,125,871 on April 1, according to the department.

The state’s total Medicaid enrollment dropped by about 248,000 during the five-month period from April 1-September 1.

In April, officials at the state Department of Human Services didn’t know whether 50,000, 150,000 or 200,000 Arkansans would lose Medicaid coverage during the six-month unwinding period, the department’s then-Chief of Staff Mark White told the House Revenue and Taxation Committee.

The continuous coverage requirement meant no Arkansans could be removed from Medicaid rolls for a change in income or eligibility until the federal public health emergency ended, and cases could be closed only if individuals moved out of state, died, were incarcerated or requested that their coverage end.

According to the Human Services Department, Arkansas’ Medicaid rolls increased by more than 230,000 during the pandemic. At the end of March 2020, the department reported 921,066 Medicaid beneficiaries. At the end of March 2023, the department reported 1,151,347 Medicaid beneficiaries.

According to the department, the 53,553 Medicaid beneficiaries who were disenrolled in September included 21,630 who failed to return the renewal form, 9,750 who failed to return requested information and 3,646 who requested that their coverage be discontinued.

In addition, the department reported that 7,321 Medicaid beneficiaries had a household income above the limit for their household size, and 5,755 did not meet the requirements of the program.

The department reported that 14,498 of the 53,553 Medicaid beneficiaries who were disenrolled in September were in the state's Medicaid expansion program called ARHOME, 10,729 were in the ARKids A program, and 5,597 were in the parent or caretaker relative program.

ARHOME stands for Arkansas Health and Opportunity for Me. The program was first authorized by the Republican-controlled Legislature and then-Democratic Gov. Mike Beebe in 2013 and has operated under a waiver granted under the federal Affordable Care Act.

In addition, the department said 6,714 Medicaid beneficiaries disenrolled in September were newborns, and 4,685 were in the qualified Medicare beneficiary program.

During these past six months, the department has reported a total of roughly 420,000 Arkansans lost Medicaid coverage because they either didn't return information needed to determine their eligibility or were no longer eligible. During the same period, the department reported a total of roughly 300,000 Medicaid beneficiaries had their coverage renewed after their eligibility was confirmed under normal eligibility rules.


Camille Richoux, health policy director at the Arkansas Advocates for Children and Families, said Monday a total of 148,617 children were disenrolled from Medicaid coverage during the state's unwinding process.

"Many if not most were removed for procedural reasons, without having their eligibility redetermined," she said in a written statement. "We agree that Medicaid resources should be available to every Arkansan who qualifies. But we know that eligible children lost coverage, including infants. That means thousands of children in Arkansas have unjustly lost access to preventative care, immunizations, and important screenings at a time critical to their healthy development. These children's coverage needs to be reinstated as soon as possible. Waiting is not an option."

Lesnick said Monday night that extensive efforts were made for the duration of the unwinding and for more than a year beforehand to ensure that eligible beneficiaries were prepared to have their coverage redetermined, with a special focus on reaching families with children.

"Arkansas Advocates for Children and Families (AACF) has not notified DHS of any eligible children who were disenrolled," he said in a written statement. "We encourage AACF to provide us with that information or ask that those families reach out to DHS directly. Beneficiaries who qualify but were disenrolled because they did not return necessary information may be able to be reinstated or reenrolled, and we are happy to assist with that."

Nicholas Horton, founder and chief executive officer for the Opportunity Arkansas group, said Monday that Arkansans deserve a strong safety net that is available and sustainable for the truly vulnerable.

"Because of the work DHS and the Sanders administration have done over the last six months, we are now significantly closer to that goal," he said in a written statement. "At the beginning of this year, there were just under 1.2 million enrollees in the Medicaid program. Thankfully, enrollment is now under 900,000 and the program is far more focused on the truly eligible."

As of Sept. 1, the department said last month, 388,558 children were Medicaid beneficiaries, 239,990 adult beneficiaries were on ARHOME and 248,996 other adults were Medicaid beneficiaries.

On April 1, the department said 469,142 children were Medicaid beneficiaries, 334,866 adult beneficiaries were on ARHOME, and 321,863 other adults were Medicaid beneficiaries.

In the federal Families First Coronavirus Response Act of March 2020, states were provided an increase of 6.2 percentage points in federal matching funds in certain Medicaid programs if they agreed to provide continuous eligibility through the federal public health emergency, according to the department.

The rate enhancement will be phased out gradually by the end of this year.

In December, the federal Consolidated Appropriations Act of 2023 granted states the authority to begin the process of redetermining the eligibility of Medicaid beneficiaries kept on the Medicaid rolls because of the continuous coverage requirement, starting April 1, and to reinstate routine eligibility operations, according to the state Department of Human Services.

Within 180 days of the expiration of restrictions on the department's ability to disenroll individuals, such as those imposed by the federal Families First Coronavirus Response Act, Arkansas Act 780 of 2021 required the department to complete and act on eligibility reevaluations for all cases that have not had a reevaluation within the past 12 months.

Act 780 was sponsored by state Sen. Scott Flippo, R-Mountain Home, who has said he had expected "tens of thousands" of Medicaid beneficiaries to be removed from the Medicaid rolls because they don't meet eligibility requirements.

The state Department of Human Services has described unwinding the continuous enrollment condition as one of the largest and most complex efforts for state Medicaid programs since the implementation of the Affordable Care Act.

In advance of the start of the unwinding of the continuous enrollment condition in April, the department pointed out that right before and during the covid-19 pandemic, Arkansas' minimum wage increased three times -- to $9.25 in 2019, to $10 in 2020, and to $11 in 2021 -- and that this would have resulted in a portion of the Medicaid beneficiaries' becoming income-ineligible for the Medicaid programs.

If beneficiaries believe their case was closed in error, they can visit for information about requesting to have their coverage reinstated if they are still eligible, reapplying, or appealing the determination, the department said Monday.

Beneficiaries who need assistance can call 855-372-1084 from 7 a.m. to 7 p.m., Monday through Saturday, according to the department. They also can submit questions through the Access Anywhere form at, or visit for additional information.