State officials plan to submit their application for a waiver to retool Arkansas' version of Medicaid expansion to President Joe Biden's administration on July 14, Gov. Asa Hutchinson said this week.
The program provides health care coverage to more than 300,000 low-income Arkansans.
In this year's regular legislative session, the Republican-dominated General Assembly approved a bill that would overhaul the state's Medicaid expansion that is now called Arkansas Works into the proposed Arkansas Health and Opportunity for Me program, or ARHOME. The federal government would continue to pay 90% of the cost of the program and the state would continue to pay the other 10%.
The Medicaid expansion program provides private health insurance coverage for adults aged between 19 and 64 who earn up to 138% of the federal poverty level, which is $17,774 for a single person and $36,570 for a family of four.
"The General Assembly has done its job and now we need the approval from the Biden administration," Hutchinson said at a news conference at the state Department of Human Services in Little Rock. He said he has a trip planned after July 14 to meet with Biden administration officials and advocate for the waiver needed to move to the proposed program.
The state seeks public comments on its plan and will hold public hearings Monday and Tuesday, he said.
Monday's hearing starts at noon and is a webinar. Details are at: https://humanservices.arkansas.gov/events/ar-behavioral-health-planning-and-advisory-council-meeting-public-hearing-for-the-arkansas-health-and-opportunity-for-me-arhome-program/
Tuesday's hearing starts at 4 p.m. and also is a webinar. Details are at: https://humanservices.arkansas.gov/events/arkansas-health-and-opportunity-for-me-arhome-program-public-hearing/
The public comment period ends July 12. After the state submits its application to the U.S. Centers for Medicare and Medicaid, the federal government will seek public comment from a federal perspective, the governor said.
"Once we get their approval, which we hope to have in November or December, which is actually critical because you have to understand that without approval of this waiver, then the current waiver ends Dec. 31, so this has to be approved in some form in order for the expanded health care that we have in Arkansas to be available," the governor said.
The work requirement in Arkansas Works hasn't been enforced since a federal judge ruled in March 2019 that federal law didn't allow then-President Donald Trump's administration to authorize that requirement in Arkansas.
State officials expect ARHOME to be serving people starting Jan. 1, 2022, Hutchinson said.
"The new approach that we have sends the message that we are serious about the health care of Arkansans," he said. "We are serious about improving their health and we are tired of being low on the totem pole, low in terms of the state rankings on health outcomes. We want to improve those in every area."
While Arkansas' version of Medicaid expansion program is unique with its use of commercial insurance, "we are adding a new ingredient to that insurance coverage and that is a new approach to improve the health of all Arkansans," Hutchinson said. The proposed new program challenges the health insurance carriers' plans to work with these people to help them get and stay healthy, he said.
State officials will continue to work with the Legislature over the life of waiver to set goals and specific outcomes for health improvement for Arkansans, he said. The state will make training and other assistance available to lift these low-income people out of poverty and into work, he said.
Under ARHOME, the state Department of Human Services plans to implement an inactive status in 2023 for people in the program who don't do things such as attend school, work, select a health insurance plan or use their health insurance in any way. Those people will be moved to fee-for-service Medicaid until they become active, according to department officials.
"We still don't know when the federal [coronavirus] public health emergency will end, so even if it does end at the end of this calendar year, you spend several months before you have redetermined your whole population," said Human Services Secretary Cindy Gillespie. "There is going to be a great deal of volatility in the population in 2022 because of the ending of the public health emergency, so that's why we are waiting until 2023."