What’s in the bill

The bills that create a framework for how the state will use federal Medicaid funds to purchase private health insurance for more than 250,000 poor Arkansans includes many specifics. Senate Bill 1020 by Sen. Jonathan Dismang, R-Searcy, and House Bill 1143 by Rep. John Burris, R-Harrison await the governor’s signature.

The bills include: A page-long section explaining that the Legislature’s intent in passing the bill is to maximize options, promote efficiencies and increase the use of private insurance while reducing the use of traditional Medicaid.

A statement saying decisions about design, operation, implementation and cost “remain within the purview of the state of Arkansas and not with Washington, D.C.”

A requirement that eligible individuals pay co-pays but not deductibles.

A definition of an eligible individual as being aged 19-65 with an income equal to or less than 138 percent of the federal poverty level. The individual also must be a U.S. citizen or qualified documented alien, and not more effectively served through traditional Medicaid. The state Department of Health has recommended keeping those with exceptional medical needs or the medically frail on the current Medicaid program so their treatment doesn’t get disrupted. Some low-risk Medicaid recipients would be moved to the private option.

The creation of the Health Care Independence Program by the Department of Human Services.

It also requires the department to apply for temporary amendments to the state Medicaid Plan and for Section 1115 federal waivers.

The waiver, in essence, exempts the new program from meeting certain federal Medicaid requirements.

A specification that implementing the program is contingent upon federal approval.

A trigger mechanism to end the program if the federal government changes the amount it will pay toward the premiums. Under the Affordable Care Act, the federal government will pay 100 percent of health-care costs for eligible individuals until 2017, after which the state will pay incrementally more of the cost until the state’s share reaches 10 percent by 2020. The shutdown would take effect if the federal government pays less than 100 percent in 2014, 2015 and 2016; and less than 95 percent in 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent in 2020 or any year after.

A requirement that the Department of Human Services seek approval by 2015 for a health savings account program that allows participants to opt in to the higher deductible health insurance.

Those participants could keep some of the money they save.

A June 30, 2017, end date for the program, unless the Legislature extends it.

The creation of a trust fund, which will be filled with savings and tax revenue from the program. The money will be used to pay the state’s portion of the premiums in the future.

A requirement that the Human Services Department promotes coverage of children through a parent’s or a caregiver’s health-insurance plan rather than through the ARKids B Program. It specifies that by 2015, the department shall seek federal approval to move many of the estimated 75,000 children to their parents’ plans on the insurance exchange.

Front Section, Pages 6 on 04/19/2013

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