The work requirement for Medicaid in Arkansas is gone, but if Governor Asa Hutchinson gets his way, it will return.
Gov. Hutchinson met with reporters Thursday to discuss Judge James “Jeb” Boasberg’s ruling that struck down the works requirements approved for Arkansas Works, the state’s Medicaid expansion program.
“I contend that Judge Boasberg is wrong,” Hutchinson said, “and I am urging the Department of Justice and (Health and Human Services) Secretary (Alex) Azar to appeal the ruling and to seek an expedited appeal of the district court’s decision.”
Hutchinson said he has spoken with Arkansas Attorney General Leslie Rutledge, Deputy Secretary of Health and Human Services Eric Hargan, as well as an attorney for HHS. Arkansas is an intervenor in the case, but not a direct party, so it does not have the ability to appeal on its own.
Last year, Arkansas became the first state to require some of its Medicaid expansion participants to prove they were either working, volunteering, or in school. If enrollees did not log 80 hours into the state’s online system for three months in a calendar year, they would lose their coverage. Many people criticized that system, saying it disadvantaged poor and rural enrollees who might not have Internet access.
“Judge Boasberg did not,” Hutchinson said, “strike down the work requirement based upon the reporting elements, that has created significant controversy here in Arkansas and media attention over the last six months. He did not strike it down based on any of the reporting requirements. He did not reach that question because he had a fundamental disagreement with the work requirement in and of itself.”
Approximately 330,000 people were enrolled in Arkansas Works at its peak. An initiative to weed out people who no longer belonged on the rolls and the implementation of the work requirement dropped the number to 235,000 today, Hutchinson said.
Roughly 18,000 people lost their insurance during the final months of 2018 because they did not meet the state’s reporting requirements. The rules allowed them to apply once again in 2019.
“Of those 18,000 that lost coverage,” Hutchinson claimed, “less than 2,000 have re-enrolled since they had that opportunity in January. Again, it could be because they have found employment in a booming economy in which employers are seeking workers, they’ve had the training that they need. But that means that 77,000 have moved off the rolls because of a job and an income since this has been in place.”
The Arkansas Department of Human Services, which manages Arkansas Works, has shut down the online reporting portal and put a notification on its website. A spokesperson said Thursday the department will send emails and letters to enrollees to let them know that they no longer have to meet the work requirement. Additionally, staff members at county health offices and the Arkansas Foundation for Medical Care, a non-profit that partners with the state to help patients and providers, will be able to answer questions in person or on the phone.
Kentucky’s work requirement was also struck down Wednesday. Hutchinson said Thursday that several other states have received waivers for work requirements or have requests pending. “Whenever you lead on a particular issue,” he stated, “particularly nationally, you have to overcome some obstacles.”
Hutchinson did not offer a timeline for when an appeal might be filed or heard and hinted that the case might go all the way to the U.S. Supreme Court.
“I remain fully committed to a work requirement,” he said, “and we are in this for the long haul because we believe it is the right policy for Arkansans who want to work and need more training and more opportunity.”
Arkansas House Speaker Matthew Shepherd (R-El Dorado) and Senate President Pro Tem Jim Hendren (R-Gravette) joined Hutchinson Thursday morning to affirm their houses’ support for a work requirement. They also indicated that Wednesday’s ruling would not affect the appropriations debate for DHS. The Senate voted earlier Wednesday to approve DHS’ budget for the next fiscal year, and Hendren said members were aware a ruling was imminent.
“Allowing a district judge to change the policy affecting 250,000 Arkansans without an opportunity to appeal is not something the Senate was willing to do,” he stated.
A work requirement, Hutchinson added, is something, “which Arkansans are in favor of. The people of Arkansas understand the importance of that, and the legislators support that. And so, with the continued fight for that work requirement, not just by us, but also by the Trump Administration, I think that weighs heavily and says, ‘let’s continue that fight.’”
Everyone who currently has health insurance through Arkansas Works will keep their coverage. People who lost it because of the work requirement must still re-apply.