Thursday, July 5, 2018
Thousands of Arkansas Works enrollees will be out of compliance with the program's work requirement unless they log into a state website by 9 p.m. today to report on their activities or exemption status for last month.
Of 11,000 enrollees who had to report whether they met the requirement or qualified for an exemption in June, more than 8,000 remained out of compliance as of late last week, Marci Manley, a spokesman for the state Department of Human Services, said in an email.
To be in compliance for the month, those enrollees must report on their activities or exemption status tonight.
Enrollees who fail to meet the requirement for three months during a year are terminated from the program for the rest of the year.
Despite efforts by the department to get the word out, many enrollees don't understand what they need to do, said James McDonald, executive director of Enroll the Ridge, a Jonesboro-based nonprofit that helps people sign up for coverage.
"What we're getting is people totally confused and people totally scared," McDonald said. "They don't want to lose their coverage, but they don't know how to go about ensuring coverage."
The federal Centers for Medicare and Medicaid Services approved Arkansas' work requirement in March. The requirement that enrollees spend 80 hours a month on work or other approved activities went into effect June 1 for an initial group of 27,000 between the ages of 30 and 49.
Of those, 16,000 qualified for automatic exemptions based on information in state records.
Those automatically exempted, for instance, include enrollees living with dependent children or who earn at least $736 a month. That cutoff is based on the average monthly income of someone making the state's minimum wage of $8.50 an hour and working 20 hours a week.
Others, such as enrollees who are full-time students or participating in a drug treatment program, can use the website, www.access.arkansas.gov, to report exemptions.
Those not exempt must use the site to report the number of hours they spent on work or other activities, such as volunteering or attending classes.
As of June 27, 371 enrollees had entered the required number of hours for June, Human Services Department spokesman Amy Webb said.
About 19,000 more enrollees, including about 11,000 who were determined to be exempt, were notified last month that they would become subject to the requirement starting on Sunday, Webb said.
Among all the nonexempt enrollees, 6,834 had set up accounts on the state website and 1,318 had accessed the part of the site used to report work activities as of June 22, she said.
The work requirement will be phased in for other enrollees ages 30-49 in August and September and next year for those ages 19-29.
When it is fully implemented, a total of about 167,000 Arkansas Works enrollees are expected to be subject to the work requirement, which applies only to enrollees with incomes up to the poverty level.
Arkansas Blue Cross and Blue Shield, one of the three insurance companies offering Arkansas Works plans, has been sharing information with insurance agents and health care providers and trying to contact its customers through letters, phone calls, emails and text messages to let them know about the requirement and offer help using the website, spokesman Max Greenwood said.
Once the company gets information on its customers' compliance in June, it will "drill further down" to try to reach those it missed, she said.
"I think that there's been challenges, as we knew there would be with this population, just making contact with them," Greenwood said. "A lot of these folks, there isn't a lot of good information on them -- for example, a good phone number or even a good address."
The program covers Arkansans who became eligible for Medicaid under the expansion of the program that took effect in 2014.
The expansion extended eligibility to adults with incomes of up to 138 percent of the poverty level. Currently that income cutoff is $16,753 for an individual or $34,638 for a family of four.
Almost 275,000 people were covered under the program as of June 1. Most receive the coverage through private insurance plans, with the state Medicaid program paying the premium.
To report on their compliance with the work requirement, enrollees must create an account on the state website, which requires having an email address. Then they must use a number listed on a notice mailed out from the department to link the account to their health coverage.
That's a challenge for many enrollees who don't have a computer and aren't comfortable using one, McDonald said.
"They don't have an email account." he said. "They're not digitally aware. Even if they have a cellphone, it's a cellphone. It's not an iPhone."
The Human Services Department announced in May that it will allow enrollees to authorize helpers to log into the website on their behalf.
The insurance companies offering Arkansas Works plans will also help with the online reports.
The assistance is available from Arkansas Blue Cross and Blue Shield at (800) 800-4298, from Centene at (877) 617-0390 and from QualChoice Health Insurance at (866) 838-9186.
Enrollees can also get one-on-one help at a Human Services Department office, Manley said.
Marquita Little, health policy director at Arkansas Advocates for Children and Families, said she's especially concerned about the homeless and people with mental illnesses or other health problems that might hinder their ability to spend the required hours on work or other activities and to use the website.
"Because this is a new requirement [and] a lot of the challenges with using technology, I do think see we'll see a portion of people that's probably higher than we would hope who will probably miss this reporting period," she said.
Manley said the Human Services Department has given information to advocacy groups and other organizations on how they can help enrollees use the state website.
The department has also been helping mental health clinics and substance abuse treatment providers to check on their patients' compliance, she said.
According to the terms of the Arkansas Works federal waiver, enrollees can apply for a "good cause exemption" if they were unable to meet the requirement for a month because of a disability or an event such as the birth or death of a family member, a natural disaster, a divorce or domestic violence.
Andy May, an insurance agent in Newport, said he expects only about 15 or 20 of his 200 customers who are in Arkansas Works plans to have to use the state website to report on their compliance or exemption status this year.
He said he has checked on some of them who hadn't heard anything about the requirement.
"All I can do is put the information out there," he said. "[But] they have to be responsible to take care of things. I can't do it for them."
A Section on 07/05/2018
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