Arkansas has approved legislation that could roll back Medicaid expansion under the Affordable Care Act.
The law requires the Arkansas Department of Health and Human Services to apply to the federal Centers for Medicare and Medicaid Services (CMS) for approval to implement changes to Arkansas Works, the state’s Medicaid program.
If approved by CMS, changes would include capping income eligibility for Medicaid to 100 percent or less of the federal poverty level (FPL) and requiring most program participants to work, starting on January 1, 2018.
The General Assembly passed the legislation “to further support efficiency and sustainability of the health insurance provided under the Arkansas Works Program,” the bill states.
The legislation, sponsored by Senate President Jonathan Dismang (R-Beebe) and House Speaker Jeremy Gillam (R-Judsonia), was signed into law by Gov. Asa Hutchinson (R) on May 4.
Arkansas expanded Medicaid in 2013 under the ACA, which requires federal taxpayers to cover 90–100 percent of the costs of newly eligible, able-bodied adults with incomes up to 138 percent of FPL.
More than 300,000 people are enrolled in Arkansas Works. Approximately 60,000 people who qualified for Medicaid expansion under Obamacare would not qualify under the new Arkansas law if CMS allows its implementation. Disenrolled individuals with incomes of at least 100 percent of FPL would qualify for federal subsidies to purchase health insurance.
More than 40 percent of Arkansans are on Medicaid, and Medicaid expansion in on track to cost Arkansas up to $1.9 billion more than proponents expected by 2021, according to a 2016 report by the Platte Institute for Economic Research and the Foundation for Government Accountability.
Dismang says Arkansas lawmakers should pass health care reforms now instead of waiting for Congress to repeal and replace Obamacare.
“At some future point, there’s no doubt in my mind that Congress will make changes and we’ll have to deal with the situation at that time,” Dismang said, according to the Associated Press. “For the moment we have right now, it makes budgetary sense for us in the State of Arkansas to make these changes.”
Arkansas state Sen. Bryan King (R-Green Forest) abstained from voting on the legislation. King says the law may not prove to be the rollback the General Assembly expects.
“While it has some things in it I like, like the work requirements, which I think are going to help throw people off [Medicaid], I don’t think it’s going to have the impact that they think it is,” King said.
King said people disenrolled from Arkansas Works will intentionally work less than they could, earning less in wages in order to qualify for greater need-based Obamacare subsidies.
“They look at this federal money like it’s free money,” King said. “How much are we saving by them going on the exchange versus how much they would have been [allocated] on the Medicaid program here?”
Arianna Wilkerson ([email protected]) is a marketing coordinator at The Heartland Institute.
Matthew Glans, “Why Arkansas’ Medicaid Rollback Could Be a Model for Expansion States,” Research & Commentary, The Heartland Institute, May 19, 2017: https://heartland.org/publications-resources/publications/research–commentary-why-arkansas-medicaid-rollback-could-be-a-model-for-expansion-states
Jonathan Ingram and Nicholas Horton, “Arkansas’ Failed Medicaid Experiment: Not a Model for Nebraska,” Platte Institute for Economic Research, January 19, 2016: https://heartland.org/publications-resources/publications/arkansas-failed-medicaid-experiment-not-a-model-for-nebraska
Arkansas state Sen. Bryan King (R-Green Forest): http://www.arkleg.state.ar.us/assembly/2013/2013R/Pages/MemberProfile.aspx?member=B.%20King
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