Arkansas waiver would axe 60,000 from Medicaid, add work requirements
Hospitals are opposing a waiver the state of Arkansas last week submitted that would mostly roll back Medicaid expansion in the state and impose a work requirement on those who remain in the program.
The waiver seeks to drop Medicaid eligibility in the state from 138% of the federal poverty level, or $33,948 for a family of four as outlined in the Affordable Care Act, to 100% of the poverty level, or $24,600 for a family of four. An estimated 60,000 people would lose Medicaid coverage.
Arkansas officials said those people likely would use tax credits and cost-sharing reduction payments to buy individual plans on the state marketplace, which is currently stable. The insurers signed up this year have said they intend to continue selling plans.
Starting Jan.1, those who remain on Medicaid would have to work, participate in job training, be in school or actively look for employment at least 80 hours a month to keep their insurance.
Those who don’t comply would lose their coverage and be blocked from Medicaid until the next calendar year.
The CMS has not yet approved such requests. But before being appointed to lead the CMS, its chief, Seema Verma, helped draft state plans that made Medicaid patients more responsible for the cost of their care.
The state of Arkansas also wants to end an ACA provision that allows peo- ple to obtain Medicaid coverage the day they apply, assuming the applicant qualifies for benefits. Providers could no longer bill for services provided in the three months before the application, assuming the patient was eligible during that time.
There’s been no estimate on how much uncompensated care could rise without retroactive eligibility, but rolling back Medicaid expansion to 100% of the poverty level could lead to as much as $54 million in uncompensated costs for hospitals by 2020, according to state calculations.