The Hutchinson administration and allied legislators rolled out their plan today for a successor to Arkansas Works, the Medicaid expansion plan built on a work requirement that was struck down in court and which the Biden administration has said it wouldn’t support.
The governor, Human Services Director Cindy Gillespie, Rep. Michelle Gray and Sen. Missy Irvin outlined the replacement dubbed ARHome, at a Capitol news conference.
Rather than a strict work requirement for able-bodied adults seeking expanded Medicaid coverage, the state will propose an “incentive” — higher-quality private insurance for those who work, are receiving education or doing other qualified activities that aren’t fully fleshed out. Otherwise, people will receive regular Medicaid coverage, which isn’t as broad and isn’t accepted by many providers.
Some critics have already expressed skepticism that the incentive will entice many people. The old work rule was poorly complied with when in effect and demonstrated little of the touted benefits. It did force tens of thousands off Medicaid coverage. The new plan will not include a monthly reporting requirement.
The Hutchinson administration is faced with pleasing both the Biden administration and legislators, many of whom had to coaxed into approving the “private option” version of Medicaid coverage that was undertaken in Arkansas. The inevitability of continuation of the Affordable Care Act and a growing interest in the lower cost of conventional fee-for-service Medicaid coverage has won some converts among the most conservative legislators, however.
The announcement today also emphasized plans for some targeted social welfare programs to help people on Medicaid.
The overall impact on the state budget isn’t clear. More fee-for-service Medicaid would cost less, but the state could lose revenue from a tax on private premiums and other factors. There’s a possibility of additional cost-sharing for people covered in the plan, officials said.
The governor said he hasn’t talked to Biden administration officials about the plan yet.