David Ramsey reports for the Arkansas Nonprofit News Network on Gov. Asa Hutchinson’s recent journey to Washington to see what’s up with federal consideration of his ideas to impose additional restrictions on Medicaid eligibility as a way to save the state money.
Arkansas began work in June on getting approval for changing the income level at which people can qualify for Medicaid coverage and also adding a work requirement. Still no answer and the plan to start the changes Jan. 1 is now out of the question. The governor remains optimistic.
“The timeline for the response to the waiver may be delayed because of the resignation of former [federal Health and Human Services] Secretary Price and the fact that the new Secretary has not yet been confirmed by the Senate,” Hutchinson wrote by email. “While the final waiver decision has not yet been made, I am confident that we are on the right track and that the reforms under Arkansas Works will continue.”
It seems there’s some concern, particularly, about lowering the eligibility determination from 138 to 100 percent of poverty. This will throw thousands off the program. They’ll still be eligible for federal subsidies in the marketplace, though whether those subsidies will be sufficient to make insurance affordable is a large question. Other political considerations also complicate a Trump administration decision on the eligibility level, Ramsey writes.
An additional complication lurks: A legal challenge to a change in income eligibility by people previously covered. There’s an argument that the eligibility level is a matter of law and can’t be waived.
Down the line, a failure of Arkansas to get the waivers would have some state budget implications in a loss of anticipated savings. Congressional efforts to end the insurance mandate under Obamacare also hold enormous implications for the entire program.