Expanding Medicaid coverage for adults in Arkansas also helped prompt a significant increase in the state’s children who are enrolled in coverage, an Arkansas Department of Human Services spokesman said Thursday.

From Aug. 31 to Monday, enrollment in Medicaid coverage among children increased by more than 22,000, raising the total to 431,121.

More children were added to the program in that time than during at least the previous three years combined.

From May 31, 2010, to Aug. 31, enrollment grew by 15,886, from 393,007, Human Services Department spokesman Amy Webb said.

The increase was highlighted Thursday by Arkansas Advocates for Children and Families, a nonprofit organization that released a report noting that of the 43,000 total children who lacked insurance in 2012, 23,000 children’s household incomes indicated they may have qualified for Medicaid coverage under ARKids First.

“We’ve made a significant dent in our number of uninsured children over the past few months,” said Anna Strong, the organization’s health-care policy director, who wrote the report.

The 2010 federal healthcare overhaul law extended eligibility for Arkansas’ ARKids First program on Jan. 1 to children with household incomes of up to 216 percent of the poverty level: $33,977 for a two-person household, for example, or $51,516 for a family of four.

Previously, children with household incomes of up to 200 percent of the poverty level were eligible for the program.

At the same time, the expansion of the state’s Medicaid program, which also took effect Jan. 1, extended eligibility to adults with incomes of up to 138 percent of the poverty level: $21,707 for a two-person household or $32,913 for a family of four.

Previously, coverage for adults was limited primarily to the elderly and disabled as well as parents with incomes of up to 17 percent of the poverty level.

To enroll in the state’s expanded Medicaid program, parents were required to enroll their children in ARKids if the children lacked coverage, Webb said.

“We weren’t exactly sure how many more kids we expected to see, but we did expect to see an increase,” Webb said.

She added that other factors, including other coverage options made available under the Patient Protection and Affordable Care Act, likely contributed to the increase.

Enrollment in the expanded Medicaid program began Oct. 1 for coverage that started in January. Under the so-called private option created under a state law passed last year, most of those who qualify receive coverage through private plans offered on the state’s health-insurance exchange, with the Medicaid program paying their premiums.

As of March 31, 155,567 applicants had been approved for coverage.

Strong also noted that children who did not qualify for Medicaid had been enrolled in coverage through the health-insurance exchange, which makes tax-credit subsidies available to certain applicants with incomes below 400 percent of the poverty level: $62,040 for two-person household, for example, or $94,200 for a family of four.

According to numbers released by the U.S. Department of Health and Human Services on Thursday, 2,347 children who did not qualify for Medicaid had been enrolled in coverage through Arkansas’ insurance exchange as of April 19.

According to Strong’s report, 20,000 of the 43,000 uninsured children in Arkansas in 2012 had household incomes above 200 percent of the poverty level.

One obstacle to obtaining coverage for some children who do not qualify for Medicaid is the health-care law’s “family glitch,” Strong said.

Under the law, if anyone in a household is eligible for employer-sponsored coverage that is deemed affordable for the employee, the entire family is ineligible for tax-credit subsidies, even if the family coverage offered is not affordable.

To reach more children who are uninsured, she said, the state Legislature should also lift restrictions on promoting enrollment that it passed during this year’s fiscal session.

Special language attached to appropriation bills reauthorizing funding for the expanded Medicaid program prohibits the Human Services Department, Department of Health and Insurance Department from promoting enrollment in Arkansas’ expanded Medicaid program or insurance exchange after June 30.

“We definitely think the Affordable Care Act and the private option are things that can help a lot of Arkansas families,” Strong said.

Rep. Nate Bell, R-Mena, who proposed the restrictions on outreach, said he would need to “take a closer look” at the effect of the legislation on enrollment in ARKids First, but added, “I rarely find myself agreeing” with Arkansas Advocates for Children and Families.

He said the restrictions are meant to slow enrollment in the private option.

“Increasing dependency on government versus encouraging people to find their own health insurance and private health coverage just isn’t productive for the economy,” Bell said.

The federal government is expected to pay the full cost of covering the state’s newly eligible adults until 2017, when Arkansas will begin paying 5 percent of the cost.

The state’s share will then increase every year until it reaches 10 percent in 2020.

The state pays between about 20 percent to 30 percent of the cost of covering children under ARKids First, depending on the child’s household income, Webb said.

The total ARKids budget for the fiscal year that ends June 30 is $106 million, she said. She added that children are the least expensive Medicaid recipients to cover and the state’s overall Medicaid expenses are below budget for the year.

Front Section, Pages 1 on 05/02/2014