by CASEY L . PENN
Arkansas Works Implements New Work Requirements What Arkansas Physicians Need to Know
Arkansas has become the third state to begin requiring work ( or its equivalent ) from ablebodied , non-exempt beneficiaries of its state-and-federally funded health insurance subsidy programs . Our program , Arkansas Works , is phasing in its newly implemented work component by age group and will eventually require all non-exempt beneficiaries ages 19-49 to work 80 hours per month or to engage in other approved activities such as job training , job searching , education , volunteering , or a combination of these .
This month , The Journal shares information pertinent to AMS members and other health care providers as they deliver medical care to patients held to these new requirements . Assisted by Mary Franklin , director of county operations for Arkansas Department of Human Resources , we will touch on some questions and concerns of our membership . But first , the basics .
Putting the Work into the Program
Arkansas Works ( formerly referred to as “ the private option ”) comprises Medicaid expansion here in Arkansas . Through the program , Medicaid pays the premiums for individual qualified health plans . Most enrollees are covered by three approved carriers : Ambetter , Arkansas Blue Cross and Blue Shield , and QualChoice . However , those considered medically frail are still served under the state ’ s traditional fee-for-service program . As of March 2018 , Arkansas Works covered health care for about 284,000 Arkansans .
The Arkansas Works legislation that passed in January 2017 included some encouragement * towards work , but it wasn ’ t until May of last year that legislation began to require work by some adult Medicaid recipients . During a May Special Session , the Arkansas General Assembly passed Act 3 , thereby enacting work requirements and adjusting eligibility of the Medicaid program from 138 % poverty level down to 100 % poverty level . Federal approval for the work part of this legislation came March 5 , 2018 , from the federal Centers for Medicare and Medicaid . ( The poverty level requirement adjustment approval is still pending but has not hindered the state from implementing the main portion of the bill .)
As mentioned , Arkansas Medicaid is phasing in the work component one age group at a time . For 2018 ( beginning June 1 ), approximately 98,000 Arkansas Works enrollees aged 30 – 49 are subject to the new work and community engagement rule ; however , of those , about 60 % have an identified exemption . Consequently , only about 40 % of enrollees in this age group are without an identified exemption and thus required to comply with the new requirements .
In 2019 , DHS will bring in the next age group . About 69,000 Arkansas Works enrollees ages 19 – 29 will become subject to the work and community engagement requirement at that time . ( Of those , about 57 % currently show an exemption identified and approximately 43 % currently do not show an identified exemption .)
Mary Franklin , DHS
Ample Notice , Gradual Phase-In
You may wonder how aware of new requirements Arkansas Works beneficiaries are , and further , if they understand their responsibilities . According to Franklin , the parties involved – DHS , Arkansas Department of Workforce Services , and the insurance carriers providing Arkansas Works qualified health plans – are working together to make sure that beneficiaries and the medical community are aware of the new requirements . In addition , the Arkansas Foundation for Medical Care , DHS ’ s vendor for Medicaid beneficiary relations , will be reaching out to Arkansas Works beneficiaries – to help them understand their requirements and the resources available to help meet them .
Since the approval of the work requirement , DHS has been sharing details on its scheduled implementation . “ DHS mailed its first of three notices to the entire Arkansas Works population by March 15 and had information out to the media and other community outlets from day one ,” said Franklin . “ The DHS communication team ( with other concerned stakeholders ) has also spread the word through libraries , legislators , social media , and health care groups that include Arkansas Foundation for Medical Care , Arkansas Hospital Association , and ( with this article ) the Medical Society .
“ That first mailing let recipients know that they will be required to provide DHS with an email address if they have not already done so , and that no other action would be needed at that time . The second notice , sent April 1 – 8 , offered full details about the work requirement , how to access and log onto its portal , and how to contact the Department of Workforce Services for help with job search and job training programs .
270 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY VOLUME 114