Medicaid Commission 'alarmed' by lost coverage in Arkansas. What, Asa worry? | Arkansas Blog

Saturday, September 15, 2018

Medicaid Commission 'alarmed' by lost coverage in Arkansas. What, Asa worry?

Posted By on Sat, Sep 15, 2018 at 12:26 PM

click to enlarge NOT MY FAULT. Gov. Asa Hutchinson talking about how well the work rule was doing after 4,300 lost coverage the first month.
  • NOT MY FAULT. Gov. Asa Hutchinson talking about how well the work rule was doing after 4,300 lost coverage the first month.

While Gov. Asa Hutchinson was touting the character-building aspect of his work requirement for Medicaid, a federal commission was expressing alarm at the first report of thousands of people losing coverage. From the New York Times:

Members of a federal advisory panel expressed alarm this week that 4,350 low-income people in Arkansas had lost Medicaid coverage because they failed to show they were complying with new work requirements held up by the Trump administration as a model for the nation.

“I hope these data scare the pants off people in Arkansas,” said Dr. Christopher Gorton, a member of the panel, called the Medicaid and CHIP Payment and Access Commission.
Dr. Gorton clearly doesn't know the controlling Repblican bloc in Arkansas, which still believes entirely too many people are getting government assistance in staying alive.

The chairwoman of the panel, Penny Thompson, said the data — the first for any state enforcing a work requirement — were “very concerning” and “very worrisome.”
Not the governor, who blamed the 4,300 who lost coverage in the first month of the work rule taking full effect for the problems. It's not the state's fault that a bunch of working poor can't figure out his computer reporting system. Or maybe they moved. Or maybe they got a job. Or maybe they just aren't deserving. Or something. Most infuriating was his implication that people "chose" not to work or comply. He doesn't know that. Many might have indeed worked and did not know about the rule. My favorite DHS outreach was on Twitter. As if.

Happily, though at least another 6,000 are in the pipeline for lost coverage next month, this federal group intends to keep watch.

The Medicaid commission — a nonpartisan agency that advises Congress, the Department of Health and Human Services and states — met in Washington on Thursday and Friday and decided to seek more information on the Arkansas program, with the aim of making recommendations later this year.

Toby Douglas, a member of the commission and a former director of the California Medicaid program, said federal and state officials should hit the “pause button” on Arkansas’s experiment until they understand why people are not responding to notices warning about the loss of Medicaid.

Of the 60,000 people subject to work and reporting requirements last month, 19,400 were already working, and 23,050 others qualified for exemptions because, for example, they were “medically frail” or had young children at home, Arkansas officials said. About 1,200 people reported meeting the work requirements after being notified of their obligation.

But 16,350 people, or 27 percent of the total, failed to meet the requirements, in most cases because they did not report any work activities.
It's not easy to reach transient poor people, as anybody with any understanding of poverty would know. Some just don't respond.

Ray Hanley, the president of the Arkansas Foundation for Medical Care, which runs a call service center for the state Medicaid program, said his organization had made telephone calls in an effort to help each of the people being removed from the rolls.

Of the 4,353 Medicaid beneficiaries, Mr. Hanley said, “many cannot be found, don’t respond, don’t return phone calls, don’t open their mail.”
Hanley, a longtime political player, defended the state's efforts and carped about critics 1,000 miles away. He said the state had made a great effort.

But lawyers for Medicaid beneficiaries said that some were unaware of the reporting requirements or did not have access to the internet and were being dropped from the rolls even though they worked or could qualify for an exemption. Alan R. Weil, another federal Medicaid commission member, said the “rapid implementation of work requirements” has proved to be “a risky proposition.”

Ms. Thompson, the chairwoman of the commission, said the panel would seek more information about the situation in Arkansas. But, she said, “it’s my sense from the commissioners that, as a group, we have a serious level of concern with the information that we are seeing.”

Panel members agreed that states, as laboratories of democracy, should be allowed to experiment. Mr. Weil said the panel was not suggesting that the work requirements were “fatally flawed,” but he added, “I’m concerned about people’s real lives.”

The article notes that the first dropouts will save the state $30 million a year. And lots more coming.

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