Nonpartisan agency asks for pause to Arkansas Medicaid work requirements

By | November 8, 2018

A nonpartisan government agency has asked the Trump administration to pause a Medicaid program in Arkansas that requires certain beneficiaries work or train for work as a condition of keeping their medical coverage.

The Medicaid and CHIP Payment and Access Commission, or MACPAC, sent a letter Thursday to Health and Human Services Secretary Alex Azar saying it was “highly concerned” that more than 8,400 people had been dropped from Medicaid rolls in Arkansas because of the policy.

“The commission calls for a pause in disenrollments in order to make program adjustments to promote awareness, reporting, and compliance,” the group wrote.

MACPAC is a nonpartisan agency that holds regular public meetings on the healthcare programs, and discussed the work requirements in September and October. The letter did not comment on the merits of the work requirements.

Arkansas was the first state to implement work requirements to its Medicaid program, which covers people making less than roughly $ 17,000 a year. The program requires certain people to log their hours online, and if they fail to do so, they are taken out of the program and are not allowed to re-enroll until the following year.

The program, MACPAC said, may not be set up in a way that allows people to successfully log the requirements, and has “high stakes for beneficiaries who fail.” The group noted it would be difficult for someone without access to the Internet or transportation to follow the requirement, and suggested Arkansas may be able to collect data on how many beneficiaries are asking for help with finding a job.

Arkansas officials have said some people who didn’t log their hours had moved to another state, obtained a job, or increased their salary and no longer qualified, while others had failed to either fulfill the requirement or to log it.

The Trump administration has supported the requirements, which it refers to as “community engagement,” to help people move out of poverty so they can obtain private coverage. It has approved similar programs to Arkansas in Wisconsin, New Hampshire, and Indiana. It approved a measure in Kentucky that has been put on hold following a legal challenge, and the Arkansas requirement also is facing a legal challenge.

Under Obamacare, states were allowed to expand government-funded Medicaid coverage to low-income people regardless of other factors such as disability status or whether they are working. Medicaid otherwise covers pregnant women, people with disabilities, people in nursing homes, and children, all of whom members of the Trump administration and conservatives say should remain the focus of the program.

Though the work requirements contain multiple exemptions for people undergoing treatment for addiction and for caregivers, among other groups, critics say people will be unable to keep up with the reporting requirements and become uninsured. They have said that the programs are an attempt to throw people off Medicaid and that tracking the work requirement is more expensive than healthcare coverage.

At least eight other states — Arizona, Kansas, Maine, Mississippi, North Carolina, Ohio, and Utah — have pending requests for similar work requirements.