About this time last month, I found myself in the uncommon position of writing an opinion column on a subject that actually affected me directly. I was writing about — criticizing, actually — Arkansas Works, the state legislature’s recent, now defunct attempt at introducing a work requirement into the state’s Medicaid expansion program.

Even more unusual is the fact that I am writing a follow-up piece covering a situation which has not worsened since the previous article. Thanks to a recent ruling by a federal judge, Arkansas Works will soon wrap up its brief tenure, and recipients need no longer worry about failing to meet the program’s work requirement standards.

Ultimately, now seems as good a time as any to discuss the flaws of Arkansas Works, as well as the program’s place in the national narrative of Medicaid dismantlement. Going forward, the era of Arkansas Works should be seen as a microcosmic moment in Arkansas legislature, seeing as a handful of other states now seek to introduce similar work requirements.

Speaking strictly on an anecdotal level, I have not changed my position on Arkansas Works since I last wrote about the program. In my previous article, I primarily criticized the program’s online work reporting component, citing major irregularities in server downtimes and general usability issues.

My difficulties reporting my work-exempt status as a student only grew in the subsequent month. The Arkansas Department of Human Services began to send me regular but conflicting messages via mail.

Sometimes, the mail confirmed that the DHS accepted the work exemptions I was reporting. Within the same month, a handful of different letters promised that my insurance would be cancelled if I did not report a valid exemption to the DHS.

The operators on the DHS help line seemed to believe the latter of these two scenarios despite all evidence to the contrary, and the only explanation I could conjure was that some sort of clerical error must have garnered me with two separate Arkansas Works profiles, both under my name.

Needless to say, I was extremely relieved when U.S. District Judge James E. Boasberg’s ruling shut down Arkansas Works, and that relief was twofold when I considered what the ruling meant for Arkansan recipients like myself.

Even if I remove myself from the program’s implications and examine only its broader ramifications, Arkansas Works was clearly a disaster. Despite the fact that the program was only in full effect between January and March, the implementation of Arkansas Works left 16,000 Arkansans uninsured, indicating that my personal experience with the work requirement program was hardly even a worst-case scenario.

Furthermore, it is not only Arkansans that benefit from Boasberg’s ruling. The ruling found that Medicaid work requirements present unconstitutional barriers to low-income individuals in need of healthcare. Twelve other states are involved in some stage of implementing their own work requirements, and there is practically no evidence to support the idea that these requirements are productive additions to state Medicaid programs.

It is entirely possible that work requirement programs are not even supposed to function in any productive capacity. The Trump administration has always been very clear in its opposition to the Patient Protection and Affordable Care Act, of which state-level Medicare programs are a key facet. Alex Azar, United States Secretary of Health and Human Services, has not only ignored the administration’s various attempts at dismantling the ACA but also remains a leading advocate of the implementation of work requirement programs.

As a result, it is important to view Arkansas’ time with Arkansas Works as an unfortunate and undeserved test case. Fortunately for Arkansans, the test did not go well in the slightest, and I think few will be disappointed if this is the last we ever see of a Medicaid work requirement. 

A previous version of this article incorrectly conflated Arkansas Works and the program’s subsidiary work requirement. They are separate legislative entities and this article has been amended to reflect that.

The Traveler strives for accuracy and clarity in all matters.


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