Arkansas' Medicaid expansion alternative survives bumpy path, gains state legislators' final approval

Apr 19 2013

The GOP-controlled legislature narrowly approved the compromise that would use federal funds to buy private insurance for low-income residents.

The Associated Press: Arkansas OKs Compromise Plan To Use Federal Medicaid Expansion Funds For Private Insurance
Arkansas' plan to use federal money to buy private insurance for low-income residents won final approval from state lawmakers Wednesday, endorsing a model that several other states are eyeing as a possible alternative to expanding Medicaid. The Republican-controlled Legislature narrowly reached the three-fourths majority needed to pass the proposal, which was a compromise reached between leading GOP lawmakers and Democratic Gov. Mike Beebe (Stratford, 4/18).

Modern Healthcare: State Reform Update: Ark. Medicaid Alternative In Spotlight As Other States Mull Similar Plans
The bumpy advance of Arkansas' unusual Medicaid plan is continuing to get notice in other conservative-leaning states. It's also likely to draw intense federal scrutiny if it keeps moving. The state's plan to expand Medicaid coverage through the private health insurance on the state's coming federal insurance exchange gained passage Tuesday in the Republican-led House, 77-23, after it failed in the same chamber a day earlier. The approach is seen as an attractive compromise in other Republican-led states where healthcare providers and others are lobbying officials to find a way to raise Medicaid eligibility and qualify for new federal funding under the Patient Protection and Affordable Care Act (Daly, 4/17).

California Healthline: Arkansas Medicaid Plan May Not Change Game After All
For seven heady weeks, Arkansas -- not Massachusetts, or Oregon, or California -- has been at the center of the health policy world. The state's eye-catching proposal to expand health coverage with Medicaid dollars but using private insurance raised questions for policy wonks and lawmakers across the nation. Was the plan legal? Was expanding coverage by relying on private payers too expensive? Would other states follow suit? ... While Republicans in several other states -- including Florida, Louisiana, Ohio, Pennsylvania, Tennessee and Texas -- had expressed interest in their own version of the private option, that ardor has cooled in recent weeks because of an HHS memo that essentially set a high bar for participation, according to Matt Salo, executive director of the National Association of Medicaid Directors (Diamond, 4/17).

Meanwhile, in Florida -

The Associated Press: Fla. Senate Panel Approves 2 Insurance Proposals
A Senate panel on Wednesday passed two very different proposals to expand health insurance for low-income Floridians under the federal health law, leaving billions of federal dollars at stake. With less than three weeks left in the Legislative session, lawmakers in the House and Senate are still worlds apart on whether to accept as much as $50 billion from the feds over the next decade to offer health coverage to roughly 1.1 million residents or to rely on state funds to cover only about 115,000 residents (Kennedy and Fineout, 4/17).

Health News Florida: Senate Panel Passes 2 Medicaid Plans: 1 Big, 1 'Teeny Weeny'
Two more different health plans for low-income people could hardly be imagined. But the Senate Appropriations Committee for Health and Human Services adopted both of them, to keep the Senate's options open in dealing with the House. House Republican leaders have refused to consider accepting any federal funds, even though an estimated $51 billion over a decade is available for the asking (Gentry, 4/17).

And in news from other states -

Des Moines Register: Critic Calls Branstad's Health Plan 'IowaCare On Steroids'
A leader of the Iowa Hospital Association warned legislators Wednesday that many poor Iowans could continue to be denied close-to-home care if the state forces them to choose hospitals participating in new Accountable Care Organizations. That idea is stressed in Gov. Terry Branstad's Healthy Iowa Plan, which is an alternative to expanding the state's Medicaid program (Leys, 4/18).

Billings (Mont.) Gazette: Montana Senate Dems, Handful Of Republicans Roll New Medicaid Program Into 'Compromise' Bill
In dramatic fashion, Senate Democrats and a handful of Republicans Tuesday defied the body's GOP leadership to cram a Medicaid proposal into a bill that would use federal dollars to buy private health insurance for thousands of uninsured, low-income Montanans. The same coalition then endorsed the measure on a 27-23 vote, setting up a final vote Thursday and a possible showdown in the state House over whether the contentious Medicaid proposal may head directly to Democratic Gov. Steve Bullock for his signature (Dennison, 4/16).