(LITTLE ROCK, Ark.) — Today, the Arkansas Department of Human Services (DHS) is reporting updated figures reflecting the third month of redeterminations as part of its required by law six-month effort to unwind the Medicaid rolls following President Biden’s ending of the Public Health Emergency (PHE). The continuous enrollment requirement during the PHE did not allow DHS to remove ineligible individuals from Medicaid. During normal eligibility rules DHS would disenroll approximately 20-30,000 ineligible individuals a month. Normal eligibility rules resumed on April 1. DHS has been working to comply with these normal eligibility rules, which are set by Congress and the Centers for Medicare and Medicaid Services. 

“There is a lot of fabricated outrage and incorrect reporting about Arkansas’ legally required efforts to redetermine eligibility for Medicaid recipients whose coverage was extended due to special rules during the COVID-19 Public Health Emergency that have since ended,” said DHS Secretary Kristi Putnam. “This outrage is misplaced, it’s coming from out-of-state media and special interest groups, and it distracts from the reality that Arkansas is following a detailed plan developed over more than a year that is both fair and helps protect Medicaid resources for those who truly need it.”

The latest figures are included in the report at the bottom of this release. In June, more than 50,000 cases were renewed after eligibility was confirmed, and approximately 77,000 beneficiaries were disenrolled because they are no longer eligible. As of July 1, total Medicaid enrollment was 971,364, including 414,722 children, 276,764 on ARHOME, and 279,878 other adults.

Procedural disenrollments

National groups have pointed to the number of procedural disenrollments, which includes beneficiaries who did not return their renewal packets. It is expected that beneficiaries who are no longer eligible for Medicaid will be disenrolled through this unwinding process. While some of these individuals will return their renewal packet and confirm that they no longer qualify, it is likely that many others simply will not return their packet because they are aware that their case will close given their change in circumstances. A closure because of a procedural reason does not mean that the packet was not received or that the beneficiary was unaware of this process.

The number of disenrollments is tied to multiple important reasons:

• There were two minimum wage increases in Arkansas during the pandemic, and unemployment has fallen from 4.9 in March 2020 to 2.7 as of May 2023. More Arkansans working for higher pay is a good thing, and it means that they are obtaining economic independence and cycling off Medicaid.
• Arkansas is redetermining eligibility for beneficiaries whose coverage would have ended if not for the special rules during the emergency. These “extended” beneficiaries are more likely to be disenrolled because they have already been determined ineligible previously, even though they kept their coverage.
• Arkansas continued eligibility operations for most of the pandemic. This means during the PHE, beneficiaries who confirmed their eligibility were transitioned off of the extended list and into categories of assistance for which they qualified. To date since the start of the emergency, more than 250,000 beneficiaries whose coverage was extended have transitioned to regular Medicaid coverage.
• Historically, DHS disenrolled 20,000 to 30,000 people each month prior to the pandemic.

“Individuals in Arkansas are transitioning off of Medicaid, and the main reason is because they are working, making more money, and have access to health care through their employers or the federal marketplace,” said Deputy Secretary and Medicaid Director Janet Mann. “This should be celebrated, not criticized.”

Renewal process

Wherever possible, eligible beneficiaries have their coverage renewed through an automated process that involves passively checking data against existing sources rather than actively requiring any new information be submitted. These renewals, called ex parte, are efficient and eliminate the need for beneficiaries to respond at all if they are confirmed to still be eligible. DHS is using these reviews at a higher level than ever before – in June, nearly 34,000 beneficiaries had their cases renewed using this automated, efficient method. 

For beneficiaries who receive renewal packets via mail, they are sent multiple notices before being disenrolled – first asking them to provide necessary information for their redetermination, and later advising them that their case is going to close if they are found to be ineligible or if they do not respond. In addition to mailings that go to all beneficiaries up for renewal, DHS attempts to reach beneficiaries by text, email, and/or phone when possible.

The disenrollments follow more than a year of outreach leading up to the end of the PHE, during which DHS made calls to recipients, met with numerous providers, partners, and stakeholder groups, conducted awareness campaigns about the need to update addresses and watch for renewal letters, engaged paid advertising, and more.

Maintaining coverage

Arkansans who are no longer eligible for Medicaid can transition to an employer-sponsored plan, or one available on the federal Health Insurance Marketplace. The Marketplace may reach out directly, but Arkansans can apply for coverage immediately by visiting healthcare.gov. Most applicants will qualify for tax credits or cost-sharing reductions that help subsidize the cost of a federal plan.

Additional information is available at ar.gov/cover.