Medicaid Work Requirements — Results from the First Year in Arkansas

The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years

“…Proposed Medicaid changes such as work requirements, which impose work as a requirement of Medicaid eligibility, have been implemented or approved in 17 states as of November 2019. These changes may cause Medicaid disenrollment and impede access to care throughout the cancer control continuum 121 . State decisions in Medicaid expansion may widen existing disparities by state expansion status in health insurance coverage and exacerbate the inequalities in access to care and cancer outcomes.…”

The State of Cancer Care in America: Impact of State Policy on Access to High-Quality Cancer Care

“…By December, the uninsured rate among 30-to 49-year-old Arkansans eligible for Medicaid increased 4% even as the employment rate declined from 42.4% to 38.9%. 1,12 In Indiana, a cost-benefit study projected the implementation of work/community engagement requirements would remove .50,000 nonelderly Medicaid eligible adults from the rolls. 13 For oncology, these findings raise legitimate concerns, because limited access to comprehensive healthcare threatens early detection and optimal treatment outcomes.…”

Administrative Burden: Policymaking by Other Means, by PamelaHerd and Donald P.Moynihan, New York, NY: Russell Sage, 2018, 360 pp., $37.50 (list).

“…A careful reading of the book leads one to realize why so often our citizenry neither trusts nor respects our governments to deliver services in a timely manner without confusion, frustration, or smothering “red tape.” Quite simply put, some who manage and implement programs and policies actually want to limit participation and not encourage it, despite the legal entitlement to benefits or, say, voting rights. If you believe government is bad and should be shrunk, or that legal immigrants and their citizen children ought to be denied access to legal rights, there are ways to make administrative burdens high enough to reduce participation and, in so doing, make the process disrespectful enough to warrant lack of trust (for example, see Herd & Moynihan, ; NPR, ; Sommers, et al., ).…”

“…The case of Wisconsin Medicaid is continuing on, however, as former Governor Walker and his legislative allies seek a waiver to work‐test Medicaid. Here they would be well advised to study the experiences of Arkansas, which required complicated online access and verification in the least online state in America, and which succeeded in reducing ”welfare” coverage to the sickest and weakest residents in the state and possibly lessening employment along the way (Sommers, et al., ). Indeed, one wonders why health insurance coverage in the United States has not fallen by more than it has since the advent of the current administration, its war on the ACA, and its waiver policies.…”