Today, the Arkansas Department of Human Services (DHS) officially asked the federal government to approve the “Arkansas Works” version of Medicaid expansion.
Arkansas Works is the newly re-branded program that was previously known as the private option (PO), a program that expanded Medicaid in Arkansas using federal Obamacare funding.
Gov. Asa Hutchinson said in a statement about the request:
The Private Option used the commercial insurance market to ensure people could go see their doctor, but it wasn’t perfect because it gave enrollees no incentive to work. As part of our reform, we want to do more than provide access to health care – we want to provide greater opportunity for Arkansans to move up the economic ladder.
Unfortunately, as we’ve written previously, just because Arkansas legislators voted to change the name of the Medicaid expansion program, it doesn’t mean any substantive policy changes were made.
Hutchinson says his “Arkansas Works” program will help enrollees “move up the economic ladder,” but there’s really not much difference between the private option and Arkansas Works.
Arkansas Works’ changes include requiring enrollees making above 100 percent of the poverty level to pay a “premium of no more than 2 percent of their household income.” However, enrollees making 100 percent of the poverty level amount to just 15 percent of the Arkansas Works enrollee population.
The remaining 85 percent of the approximately 250,000 enrollees will pay nothing.
The 15 percent of enrollees who make more than 100 percent of the federal poverty level already were already required by law to make small monthly payments to help offset the costs of the program under the private option, but only 1 percent were actually making payments.
The word is still out on whether changing the name of the program to Arkansas Works will motivate the other 99 percent to start making payments.
Interestingly enough, changes such as asset testing of enrollees and a lifetime benefits cap weren’t even a part of requested changes released today. That’s because — despite “private option” advocates’ repeated claims about the program’s “flexibility” with respect to Washington, D.C. — the Obama Administration would’ve never approved these changes.
Inflexible federal dictates are why today’s changes contained a “work referral” requirement for unemployed and “very low-income” Arkansas Works enrollees. These enrollees would be referred to “job training and job search programs” instead of actually requiring enrollees to work or actively seek employment opportunities.
That’s because a “work referral” requirement is acceptable to the Obama Administration while a “work requirement” provision would probably not have been approved.
As we’ve written before, the historical experience of Medicaid expansion shows that it slams the brakes on economic expansion and job growth. There is no reason to think that Arkansas has discovered some way to repeal the laws of supply and demand.
All in all, anyone who thinks anything major is changing with Medicaid expansion in Arkansas besides the name change is going to be sorely disappointed.