Expanding Medicaid through Waivers: The Arkansas

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

Expanding Medicaid through Waivers: The Arkansas

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