When former Gov. Mike Beebe signed the state’s plan into law in 2013, Arkansas became an early adopter of Medicaid expansion. Following the Affordable Care Act’s implementation of increased federal funding for states to expand their individual Medicaid programs, state leaders quickly worked to find a plan that met the needs of Arkansans while appealing to legislators across party lines.
Out of that compromise came the Arkansas Health Care Independence Program, which eventually transitioned to the Arkansas Works program in 2017. Instead of offering a public option to those who are eligible for Medicaid coverage, the state’s plan instead purchases private coverage for those Arkansans. Similar models have been implemented in other states following Arkansas’s lead, including Iowa and New Hampshire. Though this program helped gain the favor of some state leaders who were not enthusiastic about expansion, it has proven to be less cost effective.
Since 2013, Arkansas Works has fluctuated in availability and accessibility. Under current Gov. Asa Hutchinson, the program has seen periods of being scaled back. This included a 2017 waiver request that would cap eligibility at 100% of the federal poverty level, rather than the standard 138%, leaving many Arkansans in a coverage gap. Hutchinson has also worked to implement a work requirement, an unconstitutional eligibility restriction that resulted in several thousand Arkansans losing coverage.
In February 2020, the U.S. Court of Appeals for the D.C. circuit decided 3-0 to block the state’s waiver requesting a work eligibility restriction. Though this decision may eventually be challenged, the work requirement cannot be reinstated at this time. It’s likely that this decision will affect how and if other states will be able to implement similar restrictions in the future.
The future of Medicaid in Arkansas is a little uncertain, but one thing remains true: Protecting equitable access to Arkansas Works relies on electing sensible leaders who have the health and safety of all Arkansans in mind.
Tags: Medicaid Expansion