Coverage Losses Begin From Mean-spirited Trump Administration Medicaid Policy  

A woman holds a child, trying to calm him down. The child is three years.

The first round of data just released by the state of Arkansas (the first state nationwide to implement a work requirement with a lockout) shows that 4,353 adults lost coverage retroactively to September 1st.  The data continue to show a clear lack of awareness about the new reporting requirements with thousands more set to lose coverage next month as a result. And the data show that the policy is doing virtually nothing to incentivize more beneficiary engagement in work and volunteer activities – the purported intent of the initiative.

A recent Health Affairs piece suggested that few Arkansans even know what is happening with the new rules. While the author spoke to a small number of beneficiaries, the newly released data supports her conclusion – there is an utter lack of awareness on the ground in Arkansas regarding what is happening. Most Medicaid beneficiaries are likely not aware that they have even lost coverage and will probably only learn that they are uninsured when they next go to the doctor, try to get a prescription filled, or wind up in the hospital.

We’ve blogged about Arkansas before, and unfortunately it seems our prior conclusions remain correct. About two-thirds of those affected by the new rules (approximately 60,000) are automatically exempted by the state’s computer (i.e. around 40,000) – in other words the beneficiary takes no action. Of those who have to take some action (i.e. seek an exemption or report work hours) a minority are doing so. Our calculations suggest that 81% of beneficiaries that are currently subject to the new rules and were not automatically exempted by the computer took no action at all.

Of the 3,465 who did take action (approximately 6% of those subject to the new rules), 65% successfully requested an exemption and the remaining 1,218 satisfied the reporting requirement. As we discussed in a previous blog, this number is misleading because a further look at the state’s data finds that 828 got credit for meeting the SNAP work requirement. So this brings us down to a paltry 390 persons (or less than one percent) out of 60,000 that are newly reporting work activities.

This unfortunately reinforces my suspicions all along. The new work requirements are not designed to incentivize work as their proponents claim but rather to create insurmountable red tape hurdles that result in significant coverage losses.

Joan Alker
Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy