The Medicaid Experiment in Arkansas: Thousands Lost Coverage, Few Gained Jobs

Arkansas required beneficiaries of a program called Arkansas Works—those who obtained Medicaid as part of the Affordable Care Act’s expanded coverage—to perform at least 80 hours of work or other activities, such as volunteering or job training each month, and report them through an online portal. If they failed to comply for any three months, they would lose coverage for the remainder of the year and would need to reapply.

Most Arkansas Works recipients already were working, according to a Kaiser Family Foundation analysis. A large number were exempt from the work requirement, including those disabled or acting as caregivers.

“The goal of this requirement was not to reduce enrollment,” Gov. Hutchinson said through a spokesman. “It was to connect recipients to existing resources to help them improve their circumstances and move up the economic ladder.”

. . . In February, more than 80% of some 15,000 Arkansas Works enrollees required to report work activities to the state didn’t do so. Over the 10 months the requirement was in effect, 18,164 people lost their Medicaid coverage for failing to comply for three months.

“That shows this is a systemic problem,” said Kevin De Liban, staff attorney at Legal Aid of Arkansas, one of the groups that sued the state over the policy. “These are termination traps.”

Many who lost coverage said their health suffered because they were unable to secure needed treatment or important medications.

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