Gov. Asa Hutchinson is expected to present the details of his plan to continue the private option — with conservative tweaks and a new name, “Arkansas Works” — to the Health Reform Legislative Task Force today.

The governor met with federal officials earlier this month to hammer out an agreement on requested changes, including premiums for some beneficiaries, referrals to job training programs, and incentives for healthy behaviors. Most of Hutchinson’s framework should get the okay from the feds, but he also made a few requests likely to be turned down, such as an asset test that would impose extra costs on beneficiaries with substantial assets, such as a house worth $200,000.  See here for more details on Hutchinson’s plan and how the feds likely reacted. 

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Hutchinson needs federal permission because the state is pursuing its own unique version of Medicaid expansion, dependent on a waiver of federal rules. The current waiver, for the private option — the state’s policy using Medicaid funds to purchase private health insurance for low-income Arkansans instead of putting them in the traditional Medicaid program — expires at the end of this year. Hutchinson is now seeking to replace it with Arkansas Works, a slightly revised version of the same policy. 

The framework that will be presented today won’t be the final, official waiver. That will have to wait until later this summer, when the feds approve the state plan amendment. Instead, look for a detailed letter from federal Health and Human Services Sec. Sylvia Burwell, outlining the agreement. That won’t include all of the fine print, but it will give enough detail for legislators to determine whether they want to back the governor’s plan. By April, when the General Assembly convenes for a special session to consider Arkansas Works, the state will likely have a working draft of their application for a state plan amendment, offering even more specific details. 

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Because the Medicaid appropriation could be held hostage without 75 percent approval from both houses of the legislature, the governor’s team is working hard to secure supermajority support for his plan. Hutchinson made his pitch yesterday on the politics and policy merits of his Arkansas Works — today we should have a better idea of just what that plan entails. 

Also today, the state’s consultant, the Stephen Group, will present findings on potential avenues for savings in the traditional Medicaid program (that is, everything other than the private option). The governor has asked that the task force recommend reforms that would save $835 million over five years. 

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Support for special health care reporting made possible by the Arkansas Public Policy Panel.

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