Bill seeks to rein in Arkansas Medicaid program

Gov. Asa Hutchinson said Tuesday at the state Capitol that health care talks among governors over the weekend in Washington “strengthened” the state’s Medicaid expansion plan, which is awaiting federal approval.
Gov. Asa Hutchinson said Tuesday at the state Capitol that health care talks among governors over the weekend in Washington “strengthened” the state’s Medicaid expansion plan, which is awaiting federal approval.

A bill that would freeze enrollment in the expanded part of Arkansas' Medicaid program cleared a House committee Tuesday.

House Bill 1465, sponsored by Rep. Josh Miller, R-Heber Springs, would prohibit the state Department of Human Services from accepting any new enrollees into the program after July 1.

Miller told the House Public Health, Welfare and Labor Committee the freeze would only take effect if it were approved by the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services.

The bill doesn't say that, however. Instead it says the state agency "shall not approve new enrollment" in the program after July 1 and directs the department to "amend the Medicaid State Plan and file any and all necessary waivers with the Centers for Medicare and Medicaid Services to implement this act."

"If CMS says no, then nothing ventured, nothing gained," Miller told the committee.

He noted that the program's enrollment -- about 331,000 as of Dec. 31 -- has far exceeded the 250,000 that state officials initially estimated would be eligible.

And he said he's afraid that the state's costs will become unsustainable if efforts by Republican leaders in Congress to repeal the 2010 Patient Protection and Affordable Care Act lead to a reduction in federal funding for the expansion.

The federal government is paying 95 percent of the cost this year. Under the health care law, the federal share drops each year until it reaches 90 percent in 2020.

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"We simply can't afford" to pay a higher match rate than specified under the current law, Miller said. "Our budget's tight as all get out now with us paying 5 percent."

In an Aug. 8 opinion, Arkansas Attorney General Leslie Rutledge said that capping enrollment is not allowed under the Affordable Care Act, and that federal officials in place at that time were unlikely to approve a waiver allowing such a cap.

A spokesman for the Centers for Medicare and Medicaid Services said in an email Tuesday that the agency "cannot speculate on proposed legislation."

The House committee recommended the measure in a 13-6 vote. Those voting no included all three Democratic members and Republican Reps. Ken Henderson of Russellville and Bruce Coleman of Mountainburg.

Rep. Chris Richey, D-Helena-West Helena, said Medicaid expansion helped a friend of his -- a mother of two children who was recently divorced.

"I would hate to be shutting the door on other women like her who would need that insurance in the future," Richey said.

Gov. Asa Hutchinson is studying Miller's bill, spokesman J.R. Davis said.

Speaking with reporters Tuesday, the governor reiterated that he hopes to win approval from federal officials to limit eligibility for the expanded Medicaid program -- known in the state as Arkansas Works -- to people with incomes below the poverty level, instead of up to 138 percent of the poverty level.

He said members of the National Governors Association, which met over the weekend in Washington, D.C., are working on their own proposal for changes to the country's health care system.

"I see Arkansas Works strengthened and not jeopardized" as a result of the changes sought by the governors, Hutchinson said, referring to the name given to changes to Medicaid expansion made by the Legislature last year.

A Section on 03/01/2017

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