Expanding Medicaid through Waivers: The Arkansas

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EXPANDING MEDICAID THROUGH
WAIVERS: THE ARKANSAS
“PRIVATE OPTION”
Anna Strong, Health Policy Director
Arkansas Advocates for Children and Families
[email protected]
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
 [email protected]
 501-371-9678
ext. 119
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