The nation's first Medicaid work requirement in Arkansas was associated with a significantly lower insured rate in the state but not an increase in employment, according to a study cited by Politico and published in the New England Journal of Medicine.
The study — by researchers from the Harvard School of Public Health — found that the uninsured rate notably increased among Arkansans ages 30 to 49 last year, when the rules were implemented for this age group.
The share of uninsured Arkansans age 30 to 49 rose from 10.5 percent in 2016 to 14.5 percent in 2018, according to the study. The uninsured rate among other age groups grew from 12.3 percent to 13.1 percent during the same period.
The share of uninsured people ages 30 to 49 remained the same in Kentucky, Louisiana and Texas, which did not have Medicaid work requirements.
At the same time, the share of low-income Arkansans ages 30 to 49 working more than 20 hours per week fell from 42.4 percent in 2017 to 38.9 percent in 2018, the study found.
Medicaid work rules in Arkansas took effect in June 2018 and required that beneficiaries work, attend school, volunteer or search for jobs at least 80 hours each month to keep coverage. Beneficiaries were kicked off the Medicaid rolls if they did not meet the requirements for three consecutive months. There were exemptions, such as for disabled and pregnant individuals.
As part of the study, researchers used survey data to compare insurance coverage and employment changes among those ages 30 to 49 in Arkansas pre and post-implementation of work requirements with age groups in the state not subject to the rules.
Overall, more than 18,000 Arkansans were forced off Medicaid coverage last year for noncompliance, according to Politico, which cites state data. The publication states about 4,300 beneficiaries had gone back to the program as of mid-May.
The study "should certainly be a warning sign that there's potential for large coverage losses, potential for significant confusion," said Benjamin Sommers, MD, PhD, a professor at the Harvard School of Public Health and the study's lead author, told Politico.
But a spokesperson for the Arkansas Department of Human Services told the publication the study is not a "meaningful or thorough" evaluation and is based on data that doesn't cover a full year. Neither did the study address why most people kicked off Medicaid rolls in 2018 did not re-enroll this year when they were eligible, the spokesperson said.