Governor Seeks New Concessions From CMS To Maintain Arkansas’ Medicaid Expansion

Arkansas Gov. Asa Hutchinson is set to meet Monday with federal officials in Washington to negotiate the future of the state’s Medicaid expansion program, which leading Republicans say could be killed if it’s not changed.

No state has seen its uninsured rate fall faster since the implementation of the federal health law than Arkansas, where it has fallen more than half, to 9.1 percent, from 2013 to 2015. Most of the credit goes to the state’s decision to expand eligibility for Medicaid, which has provided coverage for around 250,000 low-income Arkansans who make up to 138 percent of the federal poverty level — about $16,000 for an individual and $33,000 for a family of four.

However, in a red state like Arkansas, dominated by anti-Obamacare lawmakers, the future of the expansion is politically tenuous. In 2013, Democratic Gov. Mike Beebe worked with a Republican-controlled legislature to craft a bipartisan compromise that became known as the “private option”: The state received a waiver from federal rules to use Medicaid funds to purchase private health insurance plans for most newly eligible beneficiaries, rather than placing them in the traditional Medicaid program.

That waiver expires at the end of 2016, and Hutchinson — Beebe’s Republican successor — is now seeking additional GOP-friendly tweaks to the program. Legislators are watching closely.

“My read on the politics is that if the federal government does not consider out-of-the-box and unprecedented measures, there’s a high likelihood that it’s not going to have the political support to get through the Arkansas legislature,” warned Republican state Sen. Jim Hendren, chairman of the state’s health reform task force (and the governor’s nephew).