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Expanding Medicaid through Waivers: The Arkansas “Private Option”

Expanding Medicaid through Waivers: The Arkansas “Private Option”. Anna Strong, Health Policy Director Arkansas Advocates for Children and Families astrong@aradvocates.org 501-371-9678 ext. 119. Arkansas’s Private Option: Overview. Acts 1497 and 1498 of 2013

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Expanding Medicaid through Waivers: The Arkansas “Private Option”

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  1. Expanding Medicaid through Waivers: The Arkansas “Private Option” Anna Strong, Health Policy Director Arkansas Advocates for Children and Families astrong@aradvocates.org 501-371-9678 ext. 119

  2. Arkansas’s Private Option: Overview • Acts 1497 and 1498 of 2013 • Use Medicaid funds to purchase private health insurance for most new eligibles through AR’s Partnership Marketplace • “High-level” silver plans only • Medicaid protections - wraparound • Budget Neutrality • Attestation that coverage is “not an entitlement” • Sunsets June 30, 2017, but waiver ends December 2016 • Exchange considerations - flexibility

  3. How did we get here? • Needed a majority vote for the enabling legislation for an expansion BUT… • Need an annual “super majority” vote for the appropriation of funds • 75 of 100 votes in the House • 27 of 35 votes in the Senate

  4. How did we get here? Takeaways: • Balancing consumer needs with political reality • Drawing a line in the sand • Strong coalition and the right messengers

  5. Consumer Concerns • Children’s coverage • Benefits (EPSDT, Transportation, Family Planning, Community Health Centers, Prescriptions) • Cost-Sharing • Access to care • Eligibility/Enrollment • Accountability, transparency, consumer protection • Budget Neutrality

  6. Consumer Representation • During session: publications, coalitions and advocacy • 1115 Waiver Public Comments by AACF • Consumer/Partner Brief • Comments on AR Department of Human Services draft • Federal comments to HHS on final • State Plan Amendments • Medically Frail questionnaire, other details

  7. Consumer Concerns Takeaways: • Make your voice heard at the state and federal level • Help partners be engaged

  8. Future Changes to Private Option • KIDS! • Parents <17% FPL! • Health Savings Accounts! • Cost-sharing 50-100% • Non-emergency Transportation • Waiver amendment transparency

  9. Future Changes to Private Option Takeaways: • Transparency for future waiver amendments is not guaranteed – but request it! • Precedent – we want what other states got

  10. Heading Toward Success? • Wins • SNAP-Facilitated Outreach – 65,000 adults, 3,000 kids • Marketplace pool is younger, much bigger • Challenges • Re-appropriating funding for Private Option • Enrollment system • Outreach/Education funding

  11. Thanks! • Anna Strong, Director of Health Policy • astrong@aradvocates.org • 501-371-9678 ext. 119

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