State Update

Arkansas Moves Forward with Alternative Medicaid Model

(State Policy, Medicare and Medicaid) Permanent link   All Posts

On April 23, Gov. Mike Beebe (D-AR) signed into law the Arkansas Private Option Bills (S.B. 1020 and H.B. 1143) that will provide health insurance for 250,000 Arkansans. The new law allows Arkansas to accept federal Medicaid funds and use those funds to pay for private insurance for “low-risk” adults newly eligible for Medicaid under the Affordable Care Act (ACA) Medicaid expansion provisions. The new law defines eligible adults as adults who: (1) are between ages 19 and 65, with an income that is equal to or less than 133% of the federal poverty level; (2) have been authenticated to be a United States citizen or a documented qualified alien; and (3) are not determined to be more effectively covered  through the standard Medicaid program, such as an individual who is medically frail or other individuals with exceptional medical needs for whom coverage through the health insurance marketplace is determined to be impractical, overly complex, or would undermine continuity or effectiveness.

Although Gov. Beebe has signed the two bills into law, the U.S. Department of Health and Human Services (HHS) must still approve the state’s alternative Medicaid expansion plan.

As you recall, in response to growing state interest in providing private health insurance to those persons eligible to receive services under the ACA Medicaid expansion provisions, the Centers for Medicare & Medicaid Services (CMS), within HHS, released a memorandum on March 29, defining and explaining the limitations on using premium assistance for private coverage in Medicaid.

Although the memorandum notes that some states have expressed interest in section 1115 demonstrations to provide premium assistance for the purchase of qualified health plans in the exchanges, and that HHS will consider approving those demonstration projects, Arkansas’ model has not been formally approved by HHS.