The nation’s first active Medicaid work requirement, approved by the Trump administration in Arkansas, has now led to nearly 17,000 people losing health coverage.

A new report from the state human services department showed that another 4,655 people have been locked out of coverage because they had failed for three months to comply with the state’s requirement that they work 80 hours a month (or some equivalent activity) as a prerequisite for receiving Medicaid. Add those folks to the 12,277 people who had already lost coverage in prior months, according to the Arkansas Times, and 16,932 low-income Arkansans have now been moved off of the health insurance program under the Medicaid work requirement.

For context, about 250,000 people are covered by Medicaid expansion in Arkansas; however, many of those people are exempt from the work requirement. Roughly 65,000 Arkansans actually needed to fulfill the state’s work requirement. About 8,400 failed to do so and, for 4,655 of them, it was their third month of noncompliance — meaning they are now locked out of coverage through the end of the year. They will be eligible to re-enroll in January.

What’s maybe most striking in the numbers is how few people are reporting their activities to the state as required. Arkansas has exempted many people — those who are working full-time, who are already meeting the work requirement for food stamps, or who are medically frail — from needing to report their activities. They are assumed to be in compliance.

But about 10,000 people were still required to report their work activities to the state. Only 1,428 actually satisfied the reporting requirement, continuing a trend from previous months; more than 8,300 people did not report any work activities at all.

The trend has become so worrisome that in November, a nonpartisan panel that advises states and the federal government on Medicaid urged Arkansas to stop disenrolling people. As the Associated Press reported:

“The low level of reporting is a strong warning signal that the current process may not be structured in a way that provides individuals an opportunity to succeed, with high stakes for beneficiaries who fail,” wrote Penny Thompson, chairman of the commission, which was created by Congress to make policy recommendations for low-income health care programs. In September, only about 1,530 met the requirement by reporting their hours, while about 16,535 failed to report any activities. Thompson said that the lack of Internet access could be hindering the state’s efforts to inform enrollees about the requirement. She also suggested that enrollees may need help finding and keeping a job.

This was one of the biggest fears for health advocates as the Trump administration touted Medicaid work requirements: that a lot of people would lose coverage not because they failed to comply but because they failed to report to the state. It seems to be coming true, at the cost of thousands more uninsured and poor citizens.