With other states expressing interest in Arkansas’ plan to provide government-funded private health insurance to 250,000 low-income Arkansans through the Medicaid program, the federal government released a memorandum Friday laying out some of the details.
The governor’s office and the state Department of Human Services stressed that the Centers for Medicare and Medicaid Services memorandum is not the final approval that Arkansas legislators have asked for.
The two-page document is the first written description from the federal government of the “private option” plan. Gov. Mike Beebe says U.S. Health and Human Services Secretary Kathleen Sebelius gave oral approval in late February for the federal government to pay premiums for private insurance companies to provide health coverage to an estimated 250,000 of the state’s poorest residents.
The new federal memorandum doesn’t say an agreement has been reached. Instead it says that “Arkansas has initiated discussions” about possible “premium assistance.”
If the Legislature approves the private-option route, the federal government will pay premiums for private health insurance companies to provide coverage through the private-insurance exchange to an estimated 250,000 of the state’s poorest residents. Initially, the federal government would pay 100 percent of the costs. The state’s share of the bill would gradually climb to 10 percent.
Arkansas legislators are weighing whether to accept the option and give the state Department of Human Services authority to move forward and spend the accompanying federal funds.
In July, the U.S. Supreme Court struck down provisions of the 2010 federal Patient Protection and Affordable Care Act and let states choose whether to extend their Medicaid programs to cover people making up to 138 percent of the federal poverty level, or $15,145 annually for an individual. The same act calls for states to set up private-insurance marketplaces called exchanges.
Some members have said they want written approval from the federal government before moving forward with the plan.
Politicians said Friday’s message is insufficient.
“I don’t see it as an official response to Arkansas,” House Republican leader Bruce Westerman, R-Hot Springs, said. “It looked to me like someone else was asking questions and [the Centers for Medicare and Medicaid Services] was just responding.”
The legislative session is to end April 19. Westerman said he doesn’t know whether members will be ready to vote on Medicaid by then.
“There’s a tremendous amount of work left to be done … and questions to be answered,” Westerman said. “I don’t think [the Centers for Medicare and Medicaid Services] can answer all those questions before we get out of session.”
Beebe spokesman Matt DeCample said that is a conundrum.
“Obviously [the Health and Human Services Department] wants to see the final plan before they give final approval, and obviously the Legislature wants final approval before they approve the legislation,” he said.
DeCample said the governor still wants a direct letter from the Health and Human Services Department on the topic.
The memorandum is in a question and answer format.
“It looks like it was written less for Arkansas and more for states that are interested in what’s happening in Arkansas. Nonetheless it’s reassuring to see them talking about the Arkansas private option plan in these terms and in this widely distributed document,” DeCample said. “There aren’t a lot of big revelations in this document.”
Department of Human Services spokesman Amy Webb said the memorandum details what the department has discussed with the federal government. She wasn’t sure Arkansas would get anything more specific.
“This is kind of [the Centers for Medicare and Medicaid Services’] guide to the country,” she said. “I think this will help lawmakers. It is [the Centers for Medicare and Medicaid Services] writing saying ‘this is the approach Arkansas is taking… and we are OK with that.’”
Many states have rejected adding thousands of people to their traditional-Medicaid rolls. Several states have expressed interest in the Arkansas plan.
The memorandum stresses that a partial expansion of service covering only some of the people below 138 percent of the poverty level is not an option. It also states that benefits offered through the private option must be comparable to Medicaid benefits.
Front Section, Pages 1 on 03/30/2013