A bill that would cover Arkansas Works enrollees through the traditional, fee-for-service Medicaid program instead of through private insurance plans fell two votes short of the 11 it needed to clear a House committee on Tuesday.
House Bill 1929's sponsor, Rep. Josh Miller, R-Heber Springs, said his proposal would save money by changing how the state provides coverage for adults with incomes of up to 138 percent of the poverty level starting July 1, 2020.
Many people became eligible for Medicaid in 2014 through the state's expansion of the program under the 2010 Patient Protection and Affordable Care Act.
Under Arkansas Works, which has 235,000 enrollees, most of those enrollees receive coverage through private insurance plans, with the Medicaid program paying most or all of the costs for the premiums.
Miller noted that the Affordable Care Act requires insurance companies to spend only 80 percent of what they collect in premiums on customers' medical expenses, meaning that up to 20 percent of the premiums end up going toward the companies' administrative expenses and profits.
"It was a novel idea, but it has gotten expensive," Miller told the House Committee on Public Health, Welfare and Labor.
[RELATED: Complete Democrat-Gazette coverage of the Arkansas Legislature]
HB1929 would also establish a task force to study changes in Medicaid reimbursement rates that may be needed to ensure recipients have access to health care providers.
Ryan James, a spokesman for the Arkansas Insurance Department, said the current Medicaid expansion coverage model, often called the "private option," has helped hold down premiums for individual insurance market plans by giving insurers more customers.
Dennis Smith, the Department of Human Services' senior adviser for Medicaid and health care reform, noted that any increase in reimbursement rates would have to be applied to all Medicaid recipients, including the 646,000 who are now covered by traditional Medicaid.
The traditional program now covers children from low-income families, poor people who are elderly or disabled, and parents with incomes of up to 17 percent of the poverty level.
Shifting Arkansas Works enrollees to traditional Medicaid would also mean ending the federal waiver that had allowed the state to impose a work requirement on Arkansas Works enrollees, he said.
If the state made plans to end the waiver, it wouldn't be able to appeal a judge's ruling last week that overturned federal officials' approval of the requirement, he said.
The bill failed to clear the 20-member committee in a 9-8 vote, with three members not voting.
A Section on 04/03/2019