Gov. Asa Hutchinson said Friday that he expects the federal government to approve a work requirement for the state's expanded Medicaid program soon, but approval of other changes may come later.
Those other changes to the program, known as Arkansas Works, include cutting 60,000 enrollees by reducing the income cap for eligibility to the poverty level, instead of 138 percent of the poverty level.
More than 285,000 people were enrolled in Arkansas Works as of Jan. 1.
"With the administration approving the guidelines of work requirements, I expect that part of the waiver to be approved in the near future," Hutchinson said in an emailed response to questions from the Arkansas Democrat-Gazette.
"We'll have to wait and see on the other elements of the waiver as Washington continues their review of our requests."
Arkansas is among 10 states that have sought approval to impose work requirements on Medicaid recipients.
President Donald Trump's administration granted Kentucky's request earlier this month, a day after issuing guidance for states that want to add such a requirement.
But the administration hasn't announced whether it will allow states to lower the income cutoff for eligibility.
Arkansas' request would limit eligibility to people with incomes of $12,140 for an individual or $25,100 for a family of four. The current cutoff is $16,753 for an individual or $34,638 for a family of four.
While reducing the number of people who qualify for Medicaid, which is funded jointly by the states and federal government, lowering the eligibility threshold would increase the number of people who are eligible for federal tax credit subsidies to help them buy private insurance.
"There is obviously a broader debate in Washington as to what this does to the whole federal Medicaid budget," Hutchinson told reporters at a Jan. 4 news conference.
At that time, however, Department of Human Services Director Cindy Gillespie said there had been no discussion about federal officials approving some of Arkansas' requested changes but not others.
Hutchinson had initially hoped the changes to Arkansas Works would be approved in time for them to take effect Jan. 1.
In light of the delay in changing the income cutoff, an advisory panel Friday recommended reducing the number of state-funded workers who help people sign up for insurance from 11 to three or four, starting March 1 and continuing until Sept. 30.
Tony Beeler, the finance director for the Arkansas Health Insurance Marketplace, said the agency has been paying for the "navigators" with the expectation that they would be needed to help people who lost eligibility for Arkansas Works.
Many of those losing Arkansas Works coverage would be eligible for tax credit subsidies to help them buy coverage offered on the state's health insurance exchange through healthcare.gov.
The marketplace approves the plans sold in the state through the federal portal and helps people enroll in them.
"We were told point blank that the waivers would be granted, and we'd be working with quite a few people to help them migrate over to the exchange from Medicaid," Beeler told the finance committee of the marketplace's board of directors.
The change in navigator funding, unanimously recommended by the finance committee, would reduce the cost of a $554,491 contract with Jonesboro-based Enroll the Ridge by $213,094.84, Beeler said. The nonprofit employs navigators and contracts with other organizations to supply the workers.
Money for the navigators and other marketplace operations comes from a fee collected from insurers that is equal to 3 percent of the premiums for non-Medicaid plans sold on the exchange.
The recommendation next goes to the full marketplace board, which meets Feb. 7.
Asked if he would be concerned about a reduction in the number of navigators, Hutchinson didn't respond directly, but said some Arkansans will need help understanding their health coverage options regardless of whether the change in eligibility for Arkansas Works is approved.
He noted that about 117,000 people moved off the state's Medicaid program last year.
"Some of those individuals have left the program because they're moving up the economic ladder, and it's important that they are aware of what's available to them on the marketplace," Hutchinson said. "Whether that outreach is done by DHS, providers or otherwise, we want to make sure they have that awareness."
Subsidized coverage on the marketplace, or exchange, is available to people who don't qualify for Medicaid or other government programs and have incomes of up to 400 percent of the federal poverty level.
Enrollment in exchange plans is generally limited to annual open enrollment periods, which run from Nov. 1 through Dec. 15 of each year. But those losing Arkansas Works coverage as a result of the change would qualify for 60-day special enrollment periods.
Almost 69,000 Arkansans signed up or re-enrolled in such plans last year for coverage taking effect Jan. 1.
Any changes to Arkansas Works would take effect about 60 days after they are approved, state officials have said.
A Section on 01/27/2018