EXPANDING MEDICAID THROUGH WAIVERS: THE ARKANSAS “PRIVATE OPTION” Anna Strong, Health Policy Director Arkansas Advocates for Children and Families astrong@aradvocates.org 501-371-9678 ext. 119 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 How did we get here? Needed a majority vote for the enabling legislation for an expansion BUT… 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 How did we get here? Takeaways: Balancing consumer needs with political reality Drawing a line in the sand Strong coalition and the right messengers 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 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 Consumer Concerns Takeaways: Make your voice heard at the state and federal level Help partners be engaged Future Changes to Private Option KIDS! Parents <17% FPL! Health Savings Accounts! Cost-sharing 50-100% Non-emergency Transportation Waiver amendment transparency Future Changes to Private Option Takeaways: Transparency for future waiver amendments is not guaranteed – but request it! Precedent – we want what other states got Heading Toward Success? Wins SNAP-Facilitated Outreach – 65,000 adults, 3,000 kids Marketplace pool is younger, much bigger Challenges Re-appropriating Enrollment funding for Private Option system Outreach/Education funding Thanks! Anna Strong, Director of Health Policy astrong@aradvocates.org 501-371-9678 ext. 119