Arkansas Legislature Approves Medicaid Expansion Alternative

by Michael Stratford, The Associated Press  on Thursday, Apr. 18, 2013 7:29 am  

Aside from federal approval, a range of logistical and policy issues would still need to be sorted out before the plan could be implemented, Medicaid experts said.

"Arkansas is putting on the table a new wrinkle in the way that states could move forward that has been attractive because it has the word 'private' in it," said Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured. "This approach has a lot of appeal to those who opposed more government being involved in health care, but the terms are going to be negotiated. The devil is always in the details."

On the one hand, providing private health insurance to low-income people could help ensure continuity if an individual's income fluctuates around the Medicaid-eligibility thresholds. But, Rowland said, the implementation of the private option would involve figuring out how a complicated set of federal Medicaid rules would interact with the private insurance plans offered in the exchange, which have yet to be determined.

Beebe said the state has been in constant contact with federal officials about the private option proposal, including a package of last-minute amendments that were made Wednesday afternoon to win support from some skeptical Republicans.

"If they run backwards on us, this all goes away," Beebe said. "So if they don't hold up their end of the deal, we won't be doing this and I won't be trying to get us to do this. All of this is predicated on the feds doing their part."

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