The Center for Budget and Policy Priorities, a liberal think tank, has issued a report ripping Gov. Asa Hutchinson’s request to the federal government to limit eligibility for Medicaid coverage to those making less than 100 percent of the federal poverty level, rather than 138 percent.
The feds have still not issued a ruling on the Arkansas request, which Hutchinson himself has said could throw 60,000 people off the expanded Medicaid coverage. He’s said these people could qualify for other premium assistance in the marketplace, but recent experience in Medicaid suggests many won’t be able to afford the coverage. The state reported yesterday that some 20 percent of the more than 300,000 who receive the expanded Medicaid coverage haven’t been able to pay the $13 monthly premium the state started demanding in January. The state is talking about taking the money from income tax refunds.
Massachusetts has joined Arkansas in seeking to shrink the income eligibility level for Medicaid. Said the Center for Budget and Policy Priorities:
These proposals are inconsistent with Medicaid’s core mission of providing comprehensive health coverage to low-income people, as well as with federal requirements that Medicaid waivers advance that objective.
If allowed to take effect, Arkansas and Massachusetts waivers would threaten healthcare coverage for thousands of low income adults.
Legal challenges are expected if the feds approve and Arkansas implements a tightening of the program. The report explains why working poor will struggle in Arkansas.
Although many of those affected would be eligible for federal tax credits to help buy coverage in the individual health insurance market, solid evidence (described below) indicates that a sizable number of them would become uninsured, while others would be left with less affordable or less adequate coverage. That’s partly because individual market plans, even with tax credits, are less affordable than Medicaid for people with incomes just above the poverty line. It’s also because some in this group would be ineligible for tax credits because their employer offers them coverage, even though that coverage would require them to pay a substantial share of their income in premiums.
Although both proposals would hurt many people, Arkansas’ would be worse for adults losing Medicaid. Unlike Arkansas, Massachusetts provides additional help to defray premiums and cover other costs to adults with incomes up to 300 percent of poverty who have marketplace coverage. That would help those between 100 and 138 percent of poverty who lose Medicaid, although marketplace plans generally leave out some benefits that Medicaid covers.