The D-G reports this morning on concerns that a lack of broadband access in rural areas could lead to an undercount in the coming Census, depriving the state of federal funds it would be entitled to. About a quarter of the state’s residents don’t have broadband access.
Of course, that issue didn’t stop state officials from requiring thousands of the state’s poorest citizens to electronically report work activities via a website in order to continue their Medicaid benefits, a bureaucratic boondoggle that has led to mass confusion and more than 12,000 people stripped of their health insurance for failure to log in.
From the D-G story, here’s demographers’ worries on how the lack of internet access could lead to an undercount in the Census, which could cost the state around $900 in federal funds per person not counted:
“My biggest concern in Arkansas is that the primary mechanism for getting answers is the Internet, and Arkansas does not have good numbers, especially in more rural populations,” said Pam Willrodt, a demographer at the Arkansas Economic Development Institute.
Willrodt has been working with the Census Bureau and communities across the state to prepare for the count, which will rely more heavily on the Internet for planning and for census-taking.
About one in every four Arkansans, or 744,572, doesn’t have broadband access, according to 2016 data from the Federal Communications Commission. Broadband is the term used to describe high-speed Internet access rather than dial-up access.
Even missing 1 percent of the population could mean that Arkansas will lose billions of dollars in federal funding for programs like school lunches, the Supplemental Nutrition Assistance Program and the Children’s Health Insurance Program, said Rich Huddleston, the executive director of Arkansas Advocates for Children and Families.
When I read this, I couldn’t help but think of the state’s Medicaid program, which is currently being sabotaged by the Hutchinson administration — taking advantage of precisely the concerns raised by the Arkansas Economic Development Institute about the Census.
By demanding that certain Medicaid beneficiaries log on to a website once a month via a convoluted process, Hutchinson has successfully purged the rolls of 12,000 low-income Arkansans, kicking them off of their health insurance and locking them out of coverage for a year.
Supposedly this is about encouraging personal responsibility and getting more people to work, but there is zero evidence that it’s done anything other than eliminate coverage for nearly all of the folks required to keep up with Governor Busybody’s electronic paperwork.
I can’t know what’s in Hutchinson’s heart, but I can tell you that if I personally was to design rules that were meant to give political cover to kick people off of their Medicaid coverage in order to save the state some money, this is more or less what I would come up with. If, just for the sake of argument, that was the real goal here, the website requirement is an ingeniously devious touch.
This does require some risible gymnastics in the PR department, however. DHS Director Cindy Gillespie told the Arkansas Nonprofit News Network’s Benji Hardy that the idea was to help people gain computer literacy skills (!). “We need to help them get an email [address] and learn how to deal in that world, or they will never be successful,” she said. Only the state invested zero resources in teaching computer literacy skills. They just took people’s health insurance away if they didn’t have those skills, didn’t have internet access at all, or didn’t manage to successfully navigate the confusing new bureaucracy created by DHS.
Don Moynihan, a professor of public policy at Georgetown, notes that nationally, 30 percent of Medicaid adults report they never use a computer, 28 percent say they do not use the internet, and 41 percent do not use email.
If work requirements were a good faith effort to help people, you would expect states to invest some resources & make it easy for people to report.
If work requirements were a de facto exercise to limit access to health insurance, you would expect to see this (via @crampell) pic.twitter.com/ojVHVZhJnj
— Don Moynihan (@donmoyn) November 20, 2018
And the human cost of creating these hurdles and this muddled bureaucracy?
If you haven’t yet, take some time to read Benji’s Arkansas Nonprofit News Network story on the Arkansas Medicaid scandal, which was the cover story of this week’s Arkansas Times. Here’s a sample:
Ruelle, 38, lost her coverage at the end of August due to Arkansas’s new requirement that certain Medicaid beneficiaries report their work hours to the state. For the past two-and-a-half months, she’s been carefully rationing both her medications, allowing herself a Gabapentin only when the nerve pain becomes so bad she fears she won’t be able to do her job. Ruelle works 25-35 hours a week at a chain restaurant in Little Rock, where she makes $9 an hour.
“It’s some serious stuff. They’re just playing around with people’s lives, and I don’t think it’s fair,” she said in a recent interview. “What if I wake up one morning and I can’t even function because my feet are hurting and I have nothing left?”
Ruelle said she first recalled hearing about the requirement in May, when she was working a minimum wage job at a different restaurant. The instructions on the notice she received from the state Department of Human Services were confusing, but she tried to do what the letter demanded.
“What happened was that I got my information and I tried to fax it to them. The fax wouldn’t go through, so I tried calling them, and I never got an answer on the phone. I went up there and they were out of the office,” she said.
When she got no reply after leaving voicemails and visiting her local DHS office, Ruelle said, she gave up. “I just quit trying, because you can only try so many times before it’s like, ‘OK, you’re closing the door in my face.’ ” …
Ruelle’s attempts to reach DHS were unsuccessful in part because the agency only allows people to report their work hours through a website, rather than by fax, phone or mail. This online-only requirement is unlike any other reporting required by DHS. The agency places no such restriction on the way beneficiaries submit other information, such as a change of address — just their work hours.
DHS first sends Arkansas Works recipients who must meet the work requirement a letter directing them to https://access.arkansas.gov. As of Nov. 16, that URL sent users to a general DHS landing page containing information about voter registration, not health insurance. From the landing page, a beneficiary must navigate a series of menus to reach a login page, where he or she is prompted to create a new account. (Doing so requires an active email address.) Then, the user must locate a unique “reference number” contained on the letter from DHS “to link your online account to your healthcare coverage.” Only then can the beneficiary enter work hours.
Ruelle said she tried to follow this process but ran into problems there, too. “You set up passwords and stuff, and the passwords won’t work. … It would tell you your user ID was invalid and then it would tell you your password’s invalid.”
“I tried to call them to help me go through all that stuff, and I couldn’t ever get a response,” she said.
p.s. As for the Census count in Arkansas — it could also be complicated by the Trump administration’s imposition of a question on citizenship (for the first time in 70 years). A number of states have sued and the matter is likely to be decided by the U.S. Supreme Court. From the D-G:
About 36 percent of Springdale’s population is Hispanic, and [Springdale Mayor Doug] Sprouse is concerned that a proposed question about whether respondents are legal citizens might cause people to skip filling out the survey altogether.
“We deal with the hand that’s dealt us, and I understand the reasoning for asking the question, but it does have the potential to complicate our efforts in getting participation,” Sprouse said.