Thousands of Arkansas Medicaid Patients Lose Coverage over Work Requirements

September 18, 2018

In Arkansas, 4,300 fewer people have health insurance through the state’s Medicaid program this week.  Another 5,000 could face a similar fate next month. Why? They failed to meet the state’s Medicaid work requirements.

As of June, the state requires able-bodied adults ages 30-49 to perform 80 hours of work or community engagement per month for three months a year.  Next year, it will also include 19-29 year-olds.

The goal is to shift people into the workforce, where they, presumably, would have medical insurance from their employer.  But meeting the work requirements could prove difficult for some. And while “medical frailty” exemptions exist, it’s not entirely clear which patients qualify.

Patients with chronic diseases in particular could be hard hit.  For example, people with cystic fibrosis, which causes decreased lung function, may struggle to maintain steady work given the amount of time it takes to manage their disease.  Someone with cystic fibrosis may spend upward of 20 hours a week doing respiratory therapy. Medicaid provides health insurance for approximately 45 percent of people with cystic fibrosis.

People with diabetes are also at risk.  As the American Diabetes Association points out, “adults with diabetes are disproportionately covered by Medicaid.” Losing coverage could mean scaling back on medication or care, proving devastating to those in fragile health.  The same is true for older Americans who often have mobility issues or face chronic conditions like high blood pressure or heart disease.  

While Arkansas is the first state to actually remove recipients from the Medicaid program, Kentucky was the first state to have work requirements approved by the federal government.  A federal judge, however, has blocked Kentucky from enforcing its rules.  

Meanwhile, work requirements are scheduled to take effect in January in Indiana and New Hampshire.  Several other states, including Virginia, are seeking federal permission.  

Advocacy communities across the country remain concerned about these policies’ impact on patient health.

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