Panel updates outreach ban for Medicaid; legislators suggest keeping rule under Arkansas Works

The Arkansas Department of Human Services would be prohibited from encouraging enrollment in the revamped version of the state's expanded Medicaid program after June 30 under special language recommended by lawmakers Monday.

Language in the appropriation bill for the department's Medical Services Division for the current fiscal year, which ends June 30, prohibits the division from promoting enrollment in the Health Care Independence Program, also known as the private option.

That language doesn't mention Arkansas Works, which, if approved by the federal government, will replace the Health Care Independence Program starting Jan. 1.

Human Services Department spokesman Amy Webb has said the department plans to promote enrollment in a part of Arkansas Works that would use Medicaid funds to help small businesses provide coverage to low-income employees.

An Aug. 17 agreement calls for the department to pay another agency, the Arkansas Health Insurance Marketplace, $300,000 through July 7 on the outreach campaign.

Gov. Asa Hutchinson has said the campaign will be critical in moving enrollees from the private option to job-based coverage under Arkansas Works.

"Arkansas Works has been approved and funded by the Legislature, and I would prefer the Legislature to give maximum flexibility in implementing the reforms included in Arkansas Works," Hutchinson said in a statement last month.

The restrictions on outreach were first proposed by Rep. Nate Bell, I-Mena, in 2014 as a way of winning support for the Medical Services Division appropriation bill, which includes funding for the expanded Medicaid program.

The expansion, first approved by the Legislature in 2013, extended coverage to adults with incomes of up to 138 percent of the poverty level: $16,394 for an individual, for instance, or $33,534 for a family of four.

In addition to helping small businesses offer insurance to their employees, Arkansas Works would require private option enrollees with incomes above the poverty level to pay premiums of about $13 a month and would refer enrollees to job training programs.

In written recommendations to the Legislature, Hutchinson's office and the Human Services Department asked that language banning outreach be removed from the Medical Services Division's appropriation bill for fiscal 2018.

Kelley Linck, chief of legislative and governmental affairs for the Human Services Department, told members of the Special Language Subcommittee of the Legislative Council's Joint Budget Committee on Monday that the department had prepared language replacing references to the Health Care Independence Program with Arkansas Works.

But he said the department didn't finish work on the replacement language until over the weekend, and it didn't submit it by the subcommittee's deadline -- 24 hours before the meeting started at noon Monday.

In a voice vote, with no members dissenting, the subcommittee recommended updating the outreach ban so it will apply to Arkansas Works instead of the Health Care Independence Program.

That was similar to the Human Services Department's proposed replacement language, according to a copy of the language provided by Webb.

The subcommittee last month recommended making a similar change to language that has barred the Arkansas Insurance Department from promoting enrollment in the Health Care Independence Program.

The full Joint Budget Committee approved the subcommittee's recommendation for the Medical Services Division appropriation later Monday, meaning the language will be included in the appropriation bill that the committee sponsors during next year's legislative session.

Under the budget approved by the committee on Monday, spending by the Medical Services Division would increase in fiscal 2018 to $7.6 billion, up from $7.2 billion in the fiscal year that ends June 30.

The federal government is expected to provide about 78 percent of the funding each year.

Webb said Monday that the division's budget for fiscal 2018 includes $125 million for the expanded Medicaid program. She said she didn't have information Monday on how much the federal government's expected share of the total will be.

Metro on 11/22/2016

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