Friday, March 17, 2017
A bill that would freeze enrollment in the expanded part of the state Medicaid program failed in a Senate committee vote Thursday after clearing the House earlier this month.
House Bill 1465, sponsored by Rep. Josh Miller, R-Heber Springs, failed in a voice vote in the Senate Public Health, Welfare and Labor Committee after officials with the state Department of Human Services testified that, rather than saving the state money, the legislation likely would increase the cost of the program to the state budget by as much as $43.5 million a year.
The bill would have frozen enrollment in Arkansas Works, as the expanded part of the program is known, on July 1.
Miller said the freeze would help control costs and enrollment while Congress considers efforts to repeal the 2010 Patient Protection and Affordable Care Act.
The federal law provided enhanced funding for states such as Arkansas that extended eligibility to adults with incomes of up to 138 percent of the poverty level.
More than 310,000 people were covered by Arkansas Works as of March 1.
David McMahon, a financial consultant to the Department of Human Services, said the enrollment cap would amount to a "four-year wind-down" of the expansion because people would continue to leave the program, but no one would be allowed to enroll.
That wind-down likely would increase the state's Medicaid costs, he said. That's because some people who would have been eligible for Arkansas Works likely would still qualify for some type of coverage under the traditional Medicaid program.
The state pays 30 percent of the cost of coverage under the traditional Medicaid program, which covers mainly poor people who are elderly or disabled as well as children from low-income families.
Under the enhanced funding for Medicaid expansion, the state is paying 5 percent of the cost this year for Arkansas Works.
The Affordable Care Act calls for the state's share to increase each year until it reaches 10 percent in 2020.
Capping enrollment also would mean the state would lose the taxes it collects from premiums paid for Arkansas Works enrollees covered by private, Medicaid-subsidized plans under the so-called private option.
According to a Human Services Department report, the net result would be a cost to state taxpayers of $22.5 million in the fiscal year that will begin July 1.
The cost would increase to $43.5 million the next fiscal year before falling to $39.5 million in fiscal 2020 and $17.2 million in fiscal 2021, according to the report.
Gov. Asa Hutchinson has said he opposes House Bill 1465. Instead, he plans to seek approval from federal authorities to limit eligibility to 100 percent of the poverty level, which he estimates would reduce enrollment by about 60,000.
Hutchinson also wants to add a work requirement to the program and provide more incentives for employers to offer insurance.
Republican Sens. David Sanders of Little Rock, and John Cooper of Jonesboro could be heard voting against the bill. That was enough to kill the motion to recommend the bill for passage because only six members were present. Approval would have required five yes votes from the eight-member committee.
A Section on 03/17/2017
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