Arkansas LegislatureArkansas PoliticsMedicaidObamacare

The “Private Option’s” War On Women (Updated)


Update, Monday, November 4th:

I received an email from DHS spokesperson Amy Webb late Friday afternoon. Apparently, she gave me incorrect information about the changes that the “private option” will have on pregnant women. Here is the email:

I have to apologize because I have given you incorrect/incomplete information related to the pregnant women Medicaid eligibility. AfterJan. 1, pregnant women up to 200% of the federal poverty level will still be eligible for Medicaid coverage. This category will still exist, but we expect it to have far fewer beneficiaries because women of child-bearing age can get full – rather than limited – coverage through the private option (if they are at or below 138%) or the federal marketplace (if they are above 138%). I assume that most women of this age group would prefer full health care coverage over limited coverage. However, if a woman between 139-200% FPL does not sign up for coverage through the marketplace and becomes pregnant, limited Medicaid coverage is still available to her. Once pregnancy Medicaid eligibility ends for a given person, DHS will let that person know that based on her income, she is eligible either for full coverage through the private option or under the ACA.
Apologies again for the error. This is such a complex topic, and I mistakenly thought that coverage above 138 went away.
Amy Webb

Earlier in the week, I wrote about the increase in Medicaid enrollment in Arkansas and the promise that, someday (over the rainbow), Medicaid rolls will actually decrease. And we can believe this because politicians who will be long gone by then have given us their word. But until that time, we’re all forced to live with increasing Medicaid rolls that we are all paying for.

In my quest to discover what exactly Arkansas’s Medicaid enrollment will look like in the coming years, DHS spokesperson Amy Webb informed me that the rolls will eventually decrease because of two factors: 1. The existing ARKids population will be transitioned onto private insurance via the “private option” and 2. Several existing Medicaid categories are “going away.” Take, for instance, the category that covers pregnant women. Webb said:

Second, several of the existing Medicaid categories are going away or transitioning over to the private option coverage. Therefore there will be fewer people on the traditional Medicaid program. For example, today Medicaid provides limited coverage for pregnant women up to 200% of the FPL. Under the ACA, pregnant women who come to us Jan. 1 and who are under 138 percent of the FPL would be directed to apply for private option coverage and those 139% and above would be directed to apply for coverage through the Marketplace.”

Here’s the kicker: under Medicaid, these pregnant women (up to 200% of FPL) currently receive health care at no cost — that is to say, the taxpayers foot the full bill. However, if this category is eliminated and those from 139-200% of FPL are forced into the “marketplace” (a.k.a. Obamacare exchanges), this will lead to significant out of pocket costs for pregnant women in Arkansas.

Take, for example, a 30-year old pregnant woman who is married to a 30-year old man. If that couple is right at 200% of federal poverty, that means they’re making $31,020 per year. According to the Kaiser Foundation’s subsidy calculator, this couple’s premium costs will be $1,954 — or over 6% of their annual income.

If the mother is single and at 200% of FPL, she makes $22,980 a year. Her premium costs will be $1,448 — or over 6% of her annual income. (Keep in mind that, before the “private option” was devised, this woman would’ve paid nothing for her medical care.)

In addition to premium costs, she’ll also have to pay co-pays and deductibles. Obamacare caps these spending amounts at $2,117 for (individual) and $4,233 (family) for a person of her income. The cost of health care for this family could exceed $6,100 or $3,500 for a single mom.

What we appear to have then, under the “private option,” is a system that will prioritize able-bodied, working age adults without children (they make up most of the “private option” population) over expectant mothers with low incomes.

From a philosophical perspective, I support the idea of having folks put “skin in the game” and pay for their own health care costs (which is why I support repealing Obamacare). But it seems to me that, due to unprecedented levels of government overreach — with the help of extraordinarily poor planning and implementation, brought to you by the Beebe Republicans in the Arkansas legislature — we are now forcing poor, pregnant Arkansans to purchase health insurance that they cannot afford. Even to a stone-cold, libertarian-leaning heart like mine, that just doesn’t seem right.

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