Since President Obama signed the ACA into law in 2010, there’s been an arms race of sorts among majority GOP-led legislatures in many Republican leaning states to lessen their share of Medicaid expenditures in myriad ways.
Last year Arkansas became the first state to establish work requirements for Medicaid beneficiaries; that is, that they were required to work 80 hours per month, participate in another qualifying community engagement activity such as job training or community service, or meet criteria for an exemption such as pregnancy or disability. The rationale would be to lighten state beneficiary rolls and help beneficiaries get out of poverty by emphasizing personal responsibility for their health care.
Critics of the plan blasted the probable outcomes (some of which were realized in this study in this week’s NEJM) in which many of the beneficiaries affected gained employment, but lost subsequent health coverage of any sort – as impacting future healthcare costs. This led, in part, to a federal judicial ruling on suspending the program earlier this year.
Though some paramters in the outcome weren’t statistically significant, an overarching theme of labyrinthine bureaucratic processes keeping many former Medicaid beneficiaries in Arkansas in the dark about the magnitude of healthcare coverage lapses in its initial year of policy implementation – emerged. LINK