Gov. Asa Hutchinson yesterday announced that the feds had signed off on an agreement for “Arkansas Works,” his plan to continue the private option, the state’s unique version of Medicaid expansion. Today, the state received a letter from federal Secretary of Health and Human Services Sylvia Burwell making it official and released the terms of the waiver agreement.
Hutchinson’s plan continues the private option, which uses Medicaid funds to purchase health insurance for 300,000 low-income Arkansans, but includes some alterations. Under “Arkansas Works,” premiums will be charged to beneficiaries who make more than the poverty line (these premiums can be no more than two percent of total income, around $20 for an individual at the poverty line), but beneficiaries will not lose coverage if they fail to pay. Unemployed beneficiaries will be referred to job training programs, but will not be required to participate, and having a job will not be a condition of coverage. Meanwhile, some beneficiaries will be covered by insurance offered by their employers rather than private option plans; Medicaid will chip in to make sure that these plans are equivalent to Medicaid in terms of costs and coverage for beneficiaries.
“Arkansas Works” will also allow the state to move away from “90-day retroactive eligibility” if it can demonstrate to the feds that it will protect continuity of coverage. This would mean beneficiaries would only be covered once they enrolled, as opposed to current Medicaid rules, which provide coverage for the three months prior to enrollment.
Here is the waiver, including terms and conditions. The waiver includes a budget neutrality agreement, requiring that the state remain beneath a per capita cost amount during the three-year life of the agreement. I’ll likely dig in with more detail on specifics later today or tomorrow.
Here’s the letter from Burwell: