Expanding Medicaid through Waivers: The Arkansas “Private Option”
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EXPANDING MEDICAID THROUGH WAIVERS: THE ARKANSAS “PRIVATE OPTION”
Anna Strong, Health Policy DirectorArkansas Advocates for Children and [email protected] ext. 119
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Arkansas’s Private Option: Overview
Acts 1497 and 1498 of 2013 Use Medicaid funds to purchase private health
insurance for most new eligibles through AR’s Partnership Marketplace “High-level” silver plans only
Medicaid protections - wraparound Budget Neutrality Attestation that coverage is “not an entitlement” Sunsets June 30, 2017, but waiver ends
December 2016 Exchange considerations - flexibility
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How did we get here? Needed a majority vote for the enabling
legislation for an expansionBUT…
Need an annual “super majority” vote for the appropriation of funds• 75 of 100 votes in
the House• 27 of 35 votes in
the Senate
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How did we get here? Takeaways:
Balancing consumer needs with political reality
Drawing a line in the sand
Strong coalition and the right messengers
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Consumer Concerns Children’s coverage Benefits (EPSDT, Transportation, Family
Planning, Community Health Centers, Prescriptions)
Cost-Sharing Access to care Eligibility/Enrollment Accountability, transparency, consumer
protection Budget Neutrality
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Consumer Representation During session: publications, coalitions
and advocacy 1115 Waiver Public Comments by AACF
Consumer/Partner Brief Comments on AR Department of Human
Services draft Federal comments to HHS on final
State Plan Amendments Medically Frail questionnaire, other details
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Consumer ConcernsTakeaways:
Make your voice heard at the state and federal level
Help partners be engaged
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Future Changes to Private Option KIDS! Parents <17% FPL! Health Savings Accounts! Cost-sharing 50-100% Non-emergency Transportation
Waiver amendment transparency
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Future Changes to Private Option
Takeaways:
Transparency for future waiver amendments is not guaranteed – but request it!
Precedent – we want what other states got
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Heading Toward Success? Wins
SNAP-Facilitated Outreach – 65,000 adults, 3,000 kids
Marketplace pool is younger, much bigger
Challenges Re-appropriating funding for Private Option Enrollment system Outreach/Education funding