Procedural disenrollment occurs when Medicaid enrollees lose coverage because they fail to complete administrative reporting requirements, not because they are actually ineligible for the program. Research on Arkansas's 2018 Medicaid work requirement found that most of the 18,000 people who lost coverage were likely eligible under the rules but didn't navigate the reporting system correctly. Procedural disenrollment is a documented consequence of adding documentation burdens to safety-net programs, particularly for populations with unstable employment, limited internet access, or health conditions that interfere with navigating bureaucratic processes.