Despite large numbers of Arkansas residents losing Medicaid eligibility under that state's work requirement law, the Trump administration is doubling down on its support of a "long list" of other states seeking to create their own Medicaid work requirements.
Speaking with reporters on Tuesday, Centers for Medicare & Medicaid Administrator Seema Verma said it is too early to draw conclusions from Arkansas' experience with Medicaid work requirement rules, noting a distinction between Arkansas' policy and how it ultimately implemented that policy.
The state requires Medicaid beneficiaries to report that they work, attend school, volunteer or search for jobs for 80 hours per month to remain eligible for coverage. Pregnant women, medically frail individuals, caregivers and other select populations are exempt. Before the policy was implemented, many expected it to result in widespread coverage losses, primarily due to the burden of reporting compliance.
"We are in discussions with them to make sure the implementation is going smoothly," Verma said, adding that the agency is also examining exactly why people have left the Medicaid program. "That’s going to give us a lot of lessons learned."
Earlier this month, the Medicaid and CHIP Payment and Access Commission (MACPAC), found that Arkansas' implementation of work requirements in its Medicaid program led to the disenrollment of more than 12,000 by the end of October, according to data released by the state. This population is locked out of the program until Jan. 1. Another 6,002 people could lose coverage in December.
Another analysis released earlier this month by the Commonwealth Fund found that as many as 48,000 adults could lose Medicaid coverage in Arkansas over the next year, leaving up to $340 million in federal funding in jeopardy.
Verma said the drop in Medicaid enrollees in Arkansas is not necessarily a bad thing.
"It’s very possible people left the program because they found a job or decided they didn’t want coverage or decided not to participate in the community engagement requirement," she said.
When asked if she thought it would be prudent to use a wait-and-see approach when it comes to approving, Verma said each state is fashioning their work requirements a bit differently and will have different experiences based on their populations.
"We have a long list of states that want to do this and want to move forward on helping people rise out of poverty. We think it’s important to allow them to do that," Verma said. "These are demonstration waivers so we think it’s important to put out as many as we can so we can learn from the different states and different approaches what works."
During her meeting on Tuesday, Verma also addressed softer open enrollment so far this year in federal and state-run health care exchanges created under the Affordable Care Act. "Our numbers are a bit lower than what they were the previous year. However, it’s still early and that could still change," Verma said. She said CMS planned to increase some of its targeted digital marketing but it is unclear where enrollment rates might actually land.
"This year the economy is booming. We’ve seen lower Medicaid enrollment in some states because people are getting jobs and might not need help paying for health insurance. That’s the same thing with the exchanges," Verma said.