Last week, federal officials at the Centers for Medicare and Medicaid Services announced that they rejected Arkansas’ request to renew the state’s Medicaid expansion (called ARHOME). This decision will take away healthcare from more than 200,000 low-income people in Arkansas. It’s a horrific decision that will devastate those most in need of the state’s help.
What is Medicaid Expansion?
The Affordable Care Act, passed in 2010 required states to expand Medicaid to cover all low-income adults. Arkansas developed a “hybrid” model to accomplish this. The ARHOME waiver allows the state to purchase coverage for folks on Medicaid using private insurance marketplaces. The state uses federal funds to pay insurance premiums for Medicaid enrollees and uses those funds to help them cover out-of-pocket costs, while private insurers manage the plans to keep the state from having to absorb those administrative costs.
This program worked incredibly well. From 2013-2016, the percentage of uninsured Arkansans dropped by 50.1%. Notably, this didn’t improve our healthcare rankings much, but that’s a separate topic. What it did do was allow people to access healthcare more consistently and set us on the path to improving healthcare rankings.
But extremists completed their takeover of the state government in 2014, and they didn’t like doing good things. They spent the next decade doing their best to slow down Medicaid expansion and nearly succeeded in 2016. They’ve been trying to kill it ever since.
What’s Happening Now?
A few weeks ago, Centene, one of the two private companies that runs the six ARHOME options, announced that they would no longer participate in the Medicaid expansion program in 2027. This will affect about a third of the Arkansans in ARHOME, who will be transferred to other eligible programs. The company stated that participating in the program was no longer sustainable, likely due to the federal cuts caused by President Trump’s signature budget bill that passed last year.
Now, ARHOME participants have seen the news that the ARHOME waiver from the federal government won’t be renewed by the end of the year. This is an existential threat to health care in the state. Thousands will lose access to care. Health care has already nearly doubled in price per month, according to KFF Health News, and during the fiscal session, the legislature already ignored those costs.
Don’t worry, though – Sen. Bart Hester (R-Cave Springs) is on it.
Wait, no, he isn’t.
When asked about the waiver, he said this: “We can’t afford it. It’s just not the government’s role to provide healthcare to people.”
But we can afford $400 million for LEARNS vouchers, remember.
So this is what the state is choosing to fund: private schools for wealthy families, and leaving 200,000 Arkansans to languish in healthcare deserts, unable to afford the care they need.
Arkansas, your leaders don’t care about you.
What’s Next?
We’re not sure. Sen. Jonathan Dismang (R-Searcy) indicated that this would take priority for the legislature from now till the next legislative session, but the federal government will need to give the state time to get this worked out. Killing the program entirely seems to be off the table, but there’s no way the program can continue to exist as it is without the federal waiver.
One immediate thing you can do: contact the federal delegation for Arkansas and tell them what Medicaid means to you. They are best positioned to put pressure on the Centers for Medicare and Medicaid to reverse their decision, which hasn’t been finalized yet.
Here’s their contact info for their Arkansas offices:
Sen. Tom Cotton: (501) 223-9081
Sen. John Boozman: (501) 372-7153
Rep. Rick Crawford:
- Jonesboro: (870) 203-0540
- Cabot: (501) 843-3043
- Mountain Home: (870) 424-2075
Rep. French Hill (R)
- Little Rock: (501) 324-5941
- Conway: (501) 902-5733
Rep. Steve Womack (R)
- Fort Smith: (479) 424-1146
- Rogers: (479) 464-0446
- Harrison: (870) 741-7741
Rep. Bruce Westerman (R)
- Hot Springs: (501) 609-9796
- El Dorado: (870) 864-8946
- Pine Bluff: (870) 536-8178
- Ozark: (479) 667-0075
