Arkansas Works, the state’s Medicaid expansion program for low-income adults, shrank for the fourth straight month in a row. The number of beneficiaries in the program decreased from about 280,000 at the beginning of May to about 275,000 on June 1. That’s a larger decline than seen in March or April.

The ongoing decrease is not due to the new work requirement that went into effect for some Arkansas Works recipients this month. Eventually, the state Department of Human Services will indeed kick people off the insurance program if they fail to meet the new work rule, but only after three months of noncompliance. That means beneficiaries won’t lose coverage due to the work requirement until September at the earliest. Also, the requirement is being phased in slowly and the majority of beneficiaries will be exempt — many of them automatically so. (I wrote about the work requirement at length this week in a story for the Arkansas Nonprofit News Network.)

So what’s behind the 5,000-person decrease in coverage? DHS says it’s a continuation of ongoing trends. Arkansas Works enrollment declined by over 10 percent from the beginning of 2017 to the beginning of 2018, a fact that Governor Hutchinson and DHS Director Cindy Gillespie highlighted in January. The governor said at the time the reduction was due to DHS scrubbing the Medicaid rolls of ineligible beneficiaries. He praised the agency for taking steps to ensure the accuracy and integrity of the Medicaid rolls, thus reducing costs.

The governor also pointed to the state’s low unemployment rate. More people working may mean more people have incomes that place them above the income eligibility cutoff for Arkansas Works, which is 138 percent of the federal poverty level. However, it’s not clear how many people who lost Arkansas Works coverage gained insurance from another source and how many joined the ranks of the uninsured.