More than 4,500 low-income Arkansans lost their health insurance over the weekend because they did not report 80 hours of work online for three consecutive months, according state data.

The three-strikes law took affect in June, making Arkansas the first state to implement Medicaid work requirements in the country. Critics warned the law wouldn’t move Medicaid recipients “out of poverty” as Gov. Asa Hutchinson (R) contends, but instead would kick people off coverage. Early data, first reported by the Arkansas Democrat Gazette, indicates this is precisely the case.

Approximately 4,574 residents did not report work or volunteer activities for June, July, and August to maintain Medicaid insurance as of Monday, said Arkansas Department of Human Services spokesperson Amy Webb. She added that the state provided individuals with a five-day grace period, giving them until Wednesday 9 p.m. local time to report work activities.

“If they do so they get their coverage back and it is retried back to the date their coverage ended so there will be no lapse in coverage,” Webb told ThinkProgress in an email. “In addition, some of those could report a change that bump them out of that category, had their case closed for other reasons, or become compliant or exempt since that Sept. 3 date.”


Additionally, the state is giving beneficiaries until October to apply for a “good cause exemption” if they faced a computer problem when attempting to report their hours. For those who ultimately fail to meet the requirement, individuals are locked out of health coverage until January 1. It is unclear whether they have been notified that their coverage has been terminated.

The official state report will be released next Thursday.

Arkansas’ Medicaid work rules haven’t even been fully implemented yet. The new policy is being phased in, affecting exclusively people between 30-49 years old. Eventually, other ages and groups (Native Americans and Alaska Natives) will have to meet the requirement.

To get a better sense of how those impacted feel about it, Health Affairs interviewed 18 recipients living in counties that supported Donald Trump in the 2016 presidential election.

“What I found was a profound lack of awareness about the policy,” wrote Health Affairs’ Jessica Greene. “A number of people were at risk for losing their Medicaid health coverage because of complex life circumstances, not because of a conscious decision related to the work requirement.”


Recipients had mixed feelings about Medicaid work requirements, saying they believe those who can work should, but that government officials didn’t account for health issues, transportation, or internet access. Arkansas has the second-lowest rate of internet access at home countrywide, which complicates matters, as recipients can only report hours online.

Three Medicaid recipients are already suing the Trump administration for approving the policy, as it threatens the coverage they need to treat their pre-existing conditions. Already, a federal judge temporarily blocked Kentucky’s slew of Medicaid changes — including work requirements — calling them “arbitrary and capricious” and concluding that officials didn’t think through how many people would lose their health plans. The newest data seems to show that Arkansas officials also didn’t think, or didn’t care, about how many people would lose coverage.