The head of the Roman Catholic church in Arkansas said in a letter to the Department of Human Services that he’s concerned that the expansion of Medicaid through private insurance plans, approved by the Legislature this year, will lead to the coverage of abortion, sterilization and contraception.
While applauding the extension of health coverage to more Arkansans, Bishop Anthony Taylor of Little Rock also complained in theTaylorletter that some “long term Arkansans” who are not U.S. citizens will “unjustly” be left out.
He also urged Human Services Department officials to address concerns that offering coverage through private plans will lower the reimbursement rates paid to the state’s 12 community health centers.
“I counsel a cautious approach,” Taylor wrote inthe letter, dated Wednesday. “There is no need for revolutionary change in the community health center arena.”
The letter was one of 15 that had been submitted as of Monday in response to the Human Services Department’s release of a draft application for a waiver of federal rules that would allow Medicaid to be expanded through the private plans.
The expansion will extend eligibility for Medicaid to adults with incomes of up to 138 percent of the federal poverty level. That threshold is $15,860 for an individual or $32,500 for a family of four.
Most of those who become eligible will enroll in private plans through an exchange, or marketplace, being set up by the federal government in partnership with the state. Medicaid will pay the recipients’ premiums using subsidies to reduce or eliminate copayments and deductibles, depending on the recipient’s income.
Act 72, passed by the Legislature during this year’s session, prohibits a private plan sold on the exchange from covering abortions,although abortion coverage can be purchased through a separate “rider.”
The federal Hyde Amendment, however, requires Medicaid to cover abortion in cases where it is necessary to save a woman’s life or when a pregnancy results from rape or incest.
Human Services Department spokesman Amy Webb said she didn’t have information on Monday on how abortion would be covered under the private option in such cases.
The Affordable Care Act requires plans sold on the health insurance exchanges that are being set up in each state to cover FDA-approved birth control methods, including tubal ligation for women.
Arkansas Deputy Insurance Commissioner Cynthia Crone said legal immigrants who have been in the U.S. for less than five years are not eligible for Medicaid, but can qualify for tax-credit subsidies to help them buy coverage on an exchange. Those in the country illegally will not be eligible for Medicaid or tax-credit subsidies.
The community health centers, which operate 83 clinics across the state, have objected to a provision in the proposed waiver that would allow the insurance plans to pay the centers according to negotiated rates, instead of the enhanced rates the centers now receive from Medicaid.
Webb said Medicaid officials are studying the issue.
“We want to make sure that the community health centers are there and thatpeople have access to them,” Webb said.
In addition to those who sent letters, more than 100 people sent emails repeating comments submitted by the Arkansas chapter of Americans for Prosperity, a conservative lobbying group.
The group said the expansion under the so-called private option would be more expensive than expanding the traditional Medicaid program and would lead to health-care rationing.
Maria Reynolds-Diaz, director of the AARP’s Arkansas chapter, sent a letter Thursday posing several questions, including how the Human Services Department would notify those eligible for coverage and how it would identify those who will be deemed “medically frail” and assigned to the traditional Medicaid program insteadof the private option.
Webb said the department will use data from programs such as food stamps to identify people who may be eligible for the expanded Medicaid program and ask them if they want to apply.
Those whose incomes qualify them for coverage will be directed to a website that will ask a series of questions to determine whether they are medically frail, she said.
She said the department has not yet established the criteria to determine who will be classified as medically frail.
The public comment period on the application ends at midnight Wednesday. The Human Services Department plans to submit the application to the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services on Aug. 2.
Northwest Arkansas, Pages 7 on 07/23/2013