More than 4,000 people lost their Medicaid benefits in Arkansas this month for not complying with the state's new work requirements.
According to numbers released by the state on Monday, 4,109 Medicaid beneficiaries were removed from the program in October.
Under the Arkansas program, beneficiaries subject to the requirement who don't meet it for three months in one year lose their benefits.
Arkansas removed 4,353 individuals from the Medicaid program last month, bringing the total number of people who have lost coverage under the state's new work requirements program to nearly 8,500.
The program launched in June after receiving approval from the Trump administration. National health-care advocates are suing the administration over Arkansas's work requirements, arguing it violates federal law.
A similar program was struck down in Kentucky by a federal judge this summer.
Under the Arkansas program, Medicaid beneficiaries who aren't exempt from the work requirements must work at least 80 hours a month. Other activities, like education and training, volunteering and searching for a job, can count toward the 80 hour requirement.
Beneficiaries subject to the requirement must file reports with the state each month detailing how they are meeting it. Failing to do so counts as noncompliance, meaning people who may be working 80 hours a month can still get kicked off the program if they don't file monthly reports.
The state's data shows the vast majority of people who have lost their coverage aren't filing reports with the state.
Of the 16,757 people who didn't meet the requirement in September, only 222 people filed reports.
Opponents of Arkansas's work requirements have worried that it would lead to coverage losses, not because people weren't working, but because they weren't filing reports.
It's unclear why so many people aren't meeting the monthly reporting requirements, but experts think it could be due to lack of awareness or confusion over the new program, although the state says it has conducted an extensive outreach campaign.
According to a brief from the nonpartisan Kaiser Family Foundation, some people who have lost coverage may qualify for an exemption from the requirements, but they are unaware of the new program.
Arkansas exempts beneficiaries who are pregnant, medically frail, have a dependent child in the home, are caring for an incapacitated person or are already working. The work requirements only apply to low-income childless adults who gained coverage through ObamaCare's Medicaid expansion.