The number of people enrolled in Arkansas Works declined again last month, from 281,033 on April 1 to 279,602 on May 1, a monthly report from the state Department of Human Services says. (Here’s the full report.)

Arkansas Works, the state’s version of Medicaid expansion, pays for health insurance for adults with incomes below 138 percent of the federal poverty level (that’s about $16,753 for an individual or $34,638 for a family of four). As the DHS report shows, Arkansas Works represents only a fraction of overall Medicaid beneficiaries. Another 236,036 adult beneficiaries are in “traditional” Medicaid, which includes populations such as elderly people, the disabled, the blind and other groups. The largest group of Medicaid beneficiaries in Arkansas, 420,117, is composed of children covered by ARKids (that program is also funded by the state Children’s Health Insurance Program, or CHIP).

That adds up to 935,755 Arkansans in all who get some or all of their health coverage from Medicaid — almost 1/3 of the population of the state.


The Arkansas Works population is typically under the most scrutiny, though, since their coverage was made possible by the Affordable Care Act, or Obamacare. Beginning in June, tens of thousands these beneficiaries will have to begin complying with a new requirement, imposed by Governor Hutchinson, that they work at least 80 hours per month or perform other activities, such as attending school or a substance abuse program. Many others will be exempt. (More details here on what qualifies as an exemption and what qualifies as “work activities.)

The decrease from April to March is consistent with recent trends in the program. Arkansas Works enrollment declined by over 10 percent from the beginning of 2017 to the beginning of 2018. Hutchinson has said the reduction is due to more effective monitoring of the rolls for ineligible beneficiaries and a strong economy pushing people into a higher income bracket (and therefore different insurance options, such as employer-based insurance or subsidized coverage purchased on the individual marketplace).


It is not clear, however, how many of the individuals who have recently lost Arkansas Works are gaining insurance from an employer or another source and how many are simply going without coverage. Since the program was created in 2013 — at the time, it was popularly called “the private option” — Arkansas has experienced the nation’s second largest decrease in the uninsured rate.