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The Great State of Arkansas, seldom singled out as an innovator in anything, was among the first states to impose work requirements for people receiving Medicaid, and tonight marks an exciting step in the effort to bone people who have made the poor choice to be poor while needing medical care: It's the very first deadline for Medicaid recipients to document that they worked or volunteered 80 hours during June, or were otherwise exempt from the work requirement. And that documentation can only be submitted online, in a state with some of the lowest internet access in the country. And of the 11,000 people required to submit records tonight, a good 8,000 hadn't yet done so as of late last week. Finally, a chance to whittle down the number of people dependent on public assistance -- somewhere, Paul Ryan is beatifically smiling.


Now, even if they don't get their paperwork filed online by tonight's deadline, those 8,000 or so Arkansans won't lose benefits right away; instead, the state's work requirement scheme works under a "three strikes" system -- if someone fails three times to show they worked or were exempt, then they lose all benefits for the rest of the year. So one miss is merely a third of the way to losing healthcare, if that makes anyone happier.

Never mind that the poor -- especially folks whose housing often changes frequently or doesn't exist at all -- are among the hardest to inform of the new rules for the private insurers who actually contract to provide Medicaid under the state's "Arkansas Works" (Or Else!) plans, as the Arkansas Democrat-Gazette reports. Max Greenwood, a spokesperson for Arkansas Blue Cross and Blue Shield, explains,

"I think that there's been challenges, as we knew there would be with this population, just making contact with them," Greenwood said. "A lot of these folks, there isn't a lot of good information on them -- for example, a good phone number or even a good address."

At least the state has already exempted some Medicaid recipients from the reporting requirements; about 16,000 people won't have to report because they have dependent children and a minimum income of $736 a month, which assumes they're making minimum wage ($8.50 an hour in Arkansas) and working 20 hours a week. Other people who are exempt, like full-time students or people in drug treatment, have to go to a state website, to tell the state they really are exempt.

Oh, this is fun, too! As of June 27, a whopping 371 people had met the reporting requirement, although maybe more will meet tonight's deadline, because almost 7,000 people had at least taken the first necessary step of setting up an online account. Still, people who help the poors report there's a lot of confusion out there:

Despite efforts by the department [of Human Services] to get the word out, many enrollees don't understand what they need to do, said James McDonald, executive director of Enroll the Ridge, a Jonesboro-based nonprofit that helps people sign up for coverage.

"What we're getting is people totally confused and people totally scared," McDonald said. "They don't want to lose their coverage, but they don't know how to go about ensuring coverage."

McDonald added that many enrollees simply don't do the internet: They don't have a computer, don't have an email account, and while they may have cell phones, they aren't necessarily smartphones. How can this possibly be? We were assured that in order to afford health insurance, the poors simply had to give up their iPhones. Which would leave them shit out of luck if they needed Medicaid, but then they wouldn't even need it, since they'd magically have insurance, you see.

For what little it's worth, the three private companies who administer Arkansas Medicaid benefits are all "allowed" to help enrollees fill out their paperwork. Isn't that nice of the state?

As we noted when Donald Trump first called for imposing work requirements for Medicaid, most Medicaid beneficiaries already work, or are retired, children, or disabled, so the work requirements are really a tool to throw people off the program. And of course the cost of administering the eligibility screenings actually makes Medicaid costlier, not more affordable. Fans of work requirements think that's fine, since a lot of people will end up being kicked off Medicaid and will therefore no longer be poor.

This first round of reporting requirements doesn't even apply to all Medicaid recipients in Arkansas. More age groups will be phased into mandatory reporting over the coming months, by which time we can expect thousands of people to have lost their eligibility for healthcare assistance until 2019, not because they don't need it, but for a failure to jump through paperwork hoops. America will then be so great that it'll simply make people sick. Literally.

The solution, of course, is for poor people to save money by staying offline, and to take some responsibility for themselves by filling out their online applications exactly on time, every month, or else.

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[Arkansas Democrat-Gazette / TPM / Illustration from Wikimedia Commons]

Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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