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Governors stand by controversial Medicaid work rules

Written on Feb 26, 2019

Republican governors defended their pursuit of applying work requirements to able-bodied Medicaid beneficiaries in the wake of thousands of people losing coverage.

Arkansas Gov. Asa Hutchinson said there needs to be consequences for people who do not meet the requirements. Hutchinson was addressing critics of the state's controversial work requirement program that has led to nearly 18,000 people in his state to lose Medicaid coverage.

The program requires able-bodied Medicaid beneficiaries to complete 20 hours a week of either work, training or volunteering.

Critics have claimed that Arkansas has made it difficult for affected Medicaid beneficiaries to report to the state because they have to report online.

In an unusual move, the nonpartisan Medicaid and CHIP Payment Advisory Commission wrote to HHS Secretary Alex Azar in November 2018 about initial reports that more than 8,000 Arkansans were kicked off Medicaid because they didn't report per the work requirements.

"While states are typically required to provide beneficiaries with multiple means of submission, the only way beneficiaries in Arkansas may report compliance is through an online portal," the commission said. "This approach may be challenging for beneficiaries given limited Internet access in the state and the multi-stage process for establishing an account and entering information."

But Hutchinson said that now beneficiaries can report in person, online or by telephone.

Arkansas is one of seven states that got approval from the CMS to create a work requirements program.

The other states are Kentucky, New Hampshire, Wisconsin, Indiana, Arizona and Michigan, according to data from the Kaiser Family Foundation.

Other than Arkansas, Indiana is the only other state to have implemented the work rules.

Maine was granted a work rules waiver in 2018 but new Democratic Gov. Janet Mills pulled the state out of the waiver after succeeding Republican Paul LePage in January. Kentucky's program has been delayed due to a court challenge. A federal judge in Washington, D.C., blocked the program from going into effect and that same judge is hearing a challenge to Arkansas' program.

Indiana's work requirement program went into effect in January, but people don't have to start reporting until July.

New Hampshire's program, which is expected to be implemented this year, requires beneficiaries to work more than other states. Affected beneficiaries must complete 25 hours a week to remain compliant as opposed to 20 hours for Arkansas.

Beneficiaries who don't comply with the requirements will face suspension from Medicaid a month after failing to report.