MARY LOUISE KELLY, HOST:
Arkansas now requires many of its Medicaid beneficiaries to work, go to school or volunteer in order to keep their health insurance. Thousands of people subject to the new rule have lost coverage in recent months, as Jacqueline Froelich of member station KUAF reports.
JAQUELINE FROELICH, BYLINE: Grisel Sustache Flores moved to Springdale, Ark., two years ago from Puerto Rico. When the 46-year-old learned she qualified for Medicaid in Arkansas - called Arkansas Works - she signed up.
GRISEL SUSTACHE FLORES: (Speaking Spanish).
FROELICH: "I was diagnosed by my doctor in Puerto Rico with multiple sclerosis," she says. Flores received physical therapy and medications to relieve symptoms and slow disease progression. But last November, her new insurance policy was canceled.
FLORES: (Speaking Spanish).
FROELICH: "I cried a lot," she says. Flores found the work verification process confusing. Starting last September, she was among 62,000 Arkansans ages 29 to 49 who were subject to the work requirement and one of more than 18,000 disenrolled by the end of the year. Under the Affordable Care Act, 37 states expanded Medicaid coverage to provide low-cost insurance to healthy low-income adults. But Arkansas and several other states also received clearance from the Trump administration to test a work rule. But these experiments take money to run, says Robin Rudowitz, with the Kaiser Family Foundation.
ROBIN RUDOWITZ: Kentucky had done some original estimates that were in the range of $375 million.
FROELICH: Arkansas spent $7.5 million in startup costs alone. The experiment, which is supposed to encourage people to work, she says, may be a burden for some.
RUDOWITZ: When we did speak with enrollees, they noted some of the new requirements were not providing additional incentives but were adding stress and anxiety to their lives.
FROELICH: Irvin Martinez says he's seen many patients struggle to navigate the online Arkansas Works portal. He's an insurance enrollment specialist at Community Clinic in Springdale, Ark.
IRVIN MARTINEZ: It's very cumbersome to get into certain areas of the website. And sometimes it's not even working because they do a lot of updates.
FROELICH: Enrollees who enter the wrong data can get locked out, he says. To help, the Arkansas Department of Human Services set up a call center late last year. And Arkansas Governor Asa Hutchinson, who initiated Arkansas Works, says the agency is doing extensive outreach to locate missing beneficiaries. He says the experiment is working.
ASA HUTCHINSON: We've already had more than 7,000 Arkansas Works participants that have moved into work.
FROELICH: Hutchinson says Medicaid case closures are often the result of churn - people moving, making too much money or securing health insurance elsewhere.
HUTCHINSON: There's not any increase in uncompensated care. There is not a huge flock of those coming back and re-enrolling this year. And so I think we're seeing that the system is removing people who have actually been ineligible for the service.
FROELICH: But Community Clinic enroller Irvin Martinez says the process of signing up and staying enrolled is cumbersome, especially for non-English-speaking beneficiaries and those who may not be as technologically connected. Grisel Sustache Flores however has, with help, re-enrolled.
FLORES: (Speaking Spanish).
FROELICH: "My new documents have arrived," she says, "and I'm learning how it works." But Flores says she is also seeking counseling to help her cope with the stress of complying with her new health insurance. For NPR News, I'm Jacqueline Froelich in Fayetteville, Ark.
KELLY: And the story is part of a reporting partnership with Kaiser Health News.
(SOUNDBITE OF MICHAEL BROOK'S "LIPKINS")
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