Since the Trump administration began allowing states to implement work requirements within their Medicaid programs, thousands of beneficiaries have been impacted, with some already losing critical healthcare coverage. Unfortunately, as more of these programs roll out, not all beneficiaries will be able to meet the requirements–simply because they aren’t aware of them, according to The New York Times.

Arkansas, the first state to implement work requirements, saw 4,300 people lose their benefits by the third month of the new rules as a result of noncompliance. More are likely to lose coverage in the coming months.

The low compliance figures suggest that many Medicaid beneficiaries may not have been aware the program existed, despite state efforts to get the word out through letters, emails, phone calls and more. But many people didn’t open their mail or answer phone calls, the NY Times reported. In addition, Arkansas’ requirements meant people could only report the hours they worked online, and the state has one of the nation’s lowest internet penetration rates.

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