Arkansas’s Failed Experiment: Work Reporting Requirements in Medicaid

Red tape leads to coverage losses, hurts workers

In June 2018, Arkansas began requiring Medicaid expansion enrollees ages 30-49 to report each month about whether or not they engaged in 80 hours of work, or other qualifying activities, in order to receive Medicaid coverage. If enrollees don’t report, or if they report insufficient hours for any three months out of the year, they lose their Medicaid coverage and are locked out from reapplying until the next calendar year.

Coverage Losses Due to Administrative Hurdles

  • Nearly 25 percent of Arkansans subject to the requirement—18,164 people—have lost coverage, although studies suggest only 6 percent wouldn’t satisfy requirements through work activities or an exemption. People who are working or should be exempt from reporting requirements are losing coverage due to unnecessary red tape.
  • Administrative roadblocks set enrollees up to fail; 4 out of every 5 people required to actively report are not meeting the documenting requirement. Some Arkansans have been made automatically exempt from reporting through data matches, but the vast majority of those required to report are not succeeding at completing paper work. Data matches to other programs have proven ineffective at ensuring success with the reporting requirement and at enabling people to continue receiving coverage given their qualifying activities.
  • Less than only 2 percent of those losing coverage actually reported that they fell short of the required hours—the vast majority has been unable to report at all. The enrollees losing coverage aren’t failing to work; they are failing to document their work through a complex administrative system.

Red Tape, Administrative Complexity, and Confusion for Enrollees

  • Enrollees report not understanding the requirements, including what steps they have to take to document their work hours, as well as how to create and connect the various online accounts necessary to report.
  • Enrollees report that losing coverage would make it harder for them to continue working.