In this letter to Department of Health and Human Services (HHS) Secretary Alex Azar, MACPAC comments on the early results of Arkansas’s work and community engagement requirements, approved under a Medicaid Section 1115 research and demonstration waiver. MACPAC is interested in the early experience from this first-in-the-nation implementation of work and community engagement requirements, not only for its effects in Arkansas, but also as a way to consider implications for HHS and other states working in this area.
MACPAC calls for a pause in disenrollments in order to make program adjustments to promote awareness, reporting, and compliance. MACPAC also asks HHS to establish mechanisms for effective evaluation and monitoring, and ensure adequate lead time for implementation before approving other states to begin enforcement of requirements that might lead to beneficiary disenrollment or lockout.