Only 1,428 low-income adults required to report their hours in November logged at least 80 hours. Roughly 8,400 failed to report 80 hours, with 98 percent of them not reporting any work activities, according to
statistics from the Arkansas Department of Human Services.
Arkansas’ Medicaid experiment has drawn ire from Democrats across the country as well as from a panel of Medicaid experts that advises Congress, which in November
asked Health and Human Services Secretary Alex Azar to stop the state from dropping people until outreach efforts are improved.
Racheal Holmes said she lost her benefits at the end of October despite going to a Department of Human Services office in Little Rock once a month to log her hours.
Holmes, who had been working at a grocery store, said it took hours just to log in to the online reporting system the first time. A state worker offered help only after a security guard noticed she was still at the office after several hours, she said.
“You couldn’t get basic assistance, as though it’s a way for you to fail,” said Holmes, who is currently unemployed and has been unable to afford medication to treat high blood pressure since her coverage lapsed. She doesn’t think the work requirements are unfair but asks, “Where’s the assistance?”
Arkansas officials point to what they describe as promising signs the requirements are working but haven't finalized plans to see whether the project is achieving its goals of helping individuals find work and improving their health.
More than 3,800 Medicaid enrollees who were subject to the work rules have found jobs since June, although it’s unclear how many of them were motivated specifically by the new requirements.
Hutchinson scoffed at critics who say the state isn't doing enough, citing examples such as the Department of Human Services making more than 155,000 phone calls to educate enrollees about the rules. The state is also planning a new advertising campaign.
“You could show that it was 100 percent successful in every way and they would still criticize it, because they don’t believe that any responsibility should have to accompany a social benefit such as Medicaid,” Hutchinson said. “The criticism is based upon myths and misunderstandings and a totally different philosophy.”
Hutchinson fought with legislators in his own party to continue the Medicaid expansion his Democratic predecessor began under Obamacare, which now covers more than 230,000 people. The governor maintains that the work requirements are a needed conservative counterweight to the health law's coverage expansion in a red state where there’s little desire to enlarge the social safety net.
A supermajority of three-fourths of the Arkansas House and Senate is required to approve funding for Medicaid expansion each year, leading to almost annual cliffhanger votes.
Hutchinson's push to institute conservative changes has given Democrats and advocates for the poor heartburn, with critics arguing Medicaid was never intended to be a jobs program. Conservatives disagree.
“It is reasonable and expected in the United States of America and especially here in conservative Arkansas that people who are able to work will do so,” said state Sen. Jason Rapert. “It is not acceptable for people to think they are entitled for other taxpayers to pay for services for them just because they do not want to work. That is not individual responsibility.”
In an interview earlier this month, Rapert said he hadn’t heard a single complaint from constituents subject to the work requirements.
But residents tell other stories. Casey Copeland, a 37-year-old who struggled with depression and drug addiction following the death of his father, said he's able to comply with the rules only by volunteering in the community and relying on financial support from his family.
“If my mom didn’t support me on the financial stuff, I couldn’t do all of it,” he said in an interview at Canvas Community Church in Little Rock, which holds a weekly dinner-and-a-movie gathering for the homeless.
Copeland was able to report his hours online using a computer at home but said the process was “very confusing.”
Department of Human Services Director Cindy Gillespie said officials are looking at the program “continuously” to see how it can be improved for enrollees.
“We’re trying to help them get to a lot of the things that exist in this state,” she said. “We’re trying not to really be fixated on what everybody else is saying outside Arkansas about the program.”
That's not much consolation for Deyo, who's figuring out how to deal with her infirmities in the new landscape.
“I have the doctors‘ notes that say I can’t work; I have their signatures,” she said. “Nobody wanted to hear that from me."