As we’ve said, state Medicaid waivers that take coverage away from people who don’t work or engage in work activities for a set number of hours each month will lead to large coverage losses — even among those who comply with the requirements or should be exempt from them. Arkansas’ approach to implementing its requirements, which took effect on June 1, will make that problem even worse.The reasons are simple. About a quarter lack Internet access. Some of those who have Intenet access rely on mobile devices and the state website isn't mobile friendly. Also, users must have an email account, something somebody without computer access is unlikely to have. Access for the visually impaired is difficult. Reporting rules are strict and access windows narrow.
That’s because the state is requiring enrollees to demonstrate compliance through a problematic online portal that poses major hardships for enrollees, many of whom don’t have Internet access. Those who don’t comply, or don’t properly report their compliance, with the requirement for three months during the year will lose their coverage.
While many states have created online portals for individuals to apply, renew, or report changes, states have always created them in addition to other access points, giving enrollees multiple ways to interact with state agencies, including phone and in-person access at local eligibility offices. Making the online portal the exclusive means of communication, as Arkansas is doing, presents major challenges for enrollees:
The state hasn’t hired additional staff to answer questions or make accommodations for individuals with disabilities. “If you implement [work requirements] in the old-fashioned way of ‘Come into our county office,’” Arkansas Human Services Director Cindy Gillespie said, “we would have to hire so many people — and that just doesn’t make sense.” But by not investing in staff and other resources to support enrollees who should be exempt or need help complying with the requirements, Arkansas is creating a bureaucratic maze that will cause many eligible enrollees to lose coverage.