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The House on Wednesday voted to halt enrollment into the Arkansas Works program after a debate about what the federal government is likely to do to change health care policy.

House Bill 1465 by Rep. Josh Miller, R-Heber Springs, passed 55-32. It heads to the Senate for further consideration.

Miller told lawmakers that Arkansas would require a waiver from the federal government to freeze enrollment in the state's Medicaid-expansion program.

But the bill says the state "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."

"Currently, we have over 330,000 folks on the program today," he said. "We are on an unsustainable path, especially with the looming new acts that are going to come out of Washington, D.C."

State lawmakers don't know what the federal government is going to do with the Patient Protection and Affordable Care Act, much less if the state will receive the same federal support for Medicaid expansion, Miller said.

Gov. Asa Hutchinson opposes the bill, J.R. Davis, a spokesman, said Wednesday evening.

"I think we all agree that the number, the 330,000 number, is too high, but we believe we have a plan to truly reform the program as opposed to freezing it, which doesn't solve the problems," Davis said.

State officials initially estimated that about 250,000 Arkansans would be eligible.

Additional details will be forthcoming, Davis said. The plan includes asking the federal government to limit the program to those at 100 percent of the poverty level instead of at the current 138 percent level. Another plan is to implement a work requirement.

Those changes are likely to be approved under President Donald Trump's administration, Davis said.

Additionally, "under Rep. Miller's bill, you could deny coverage to someone who really needs it," he said.

Wednesday's House debate focused on conflicting rumors about how Trump is likely to change the Affordable Care Act, also known as Obamacare.

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Those who supported HB1465 said the federal government is likely to increase the state's obligation for Arkansas Works.

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. The private option cost about $1.5 billion in 2016. If the cost stayed the same, the state would need to provide $150 million of the funding in 2020.

"A couple of the plans absolutely bump that matching rate up to 15 [percent] or 20 percent or more," said Rep. David Meeks, R-Conway.

"We can't afford that. Right now the projection is that if we have to do 15 [percent] or 20 percent, we're talking a $500 [million] to $600 million shortfall in our budget. And so I think what Rep. Miller has proposed is very prudent."

But some of those against HB1465 said the federal government is more likely to turn to block grants -- a fixed amount of money for the states -- to rein in the Medicaid budget.

Rep. Deborah Ferguson, D-West Memphis, said she believed block grants are more likely. If so, trimming program costs now would hurt funding later, she said.

"By eliminating more people on the program, we could actually hurt our state funding going forward," she said. "We could actually get less money by reducing the number of people because if they go to a block grant, our base-line funding will be based on when we enter the program."

Trump has promised to repeal and replace the Affordable Care Act, which expanded Medicaid, set up health insurance exchanges and subsidies to buy insurance, and required adults to have insurance, among other things.

A U.S. Supreme Court decision allowed states to choose whether to expand Medicaid. Arkansas, under then-Gov. Mike Beebe, adopted the private option to do so, using the funds to buy private insurance plans for those newly eligible for Medicaid.

Hutchinson refined the private option to create Arkansas Works.

Trump has not said what replacing the Affordable Care Act will look like or what it will mean for the 32 states that expanded Medicaid.

However, a report by the consulting firms Avalere Health and McKinsey & Co. presented to the governors during National Governors Association meetings this week concluded that the changes under consideration by the GOP-led U.S. House would reduce significantly federal funding for Medicaid, creating funding gaps for states and threatening a loss of coverage for many participants.

A Section on 03/02/2017

Print Headline: House OKs freeze on Medicaid expansion


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