LITTLE ROCK – The Arkansas Human Services Department has officially petitioned the federal government for authority to make changes in the Medicaid expansion program.
The program is known as ARHOME and provides health coverage to about 312,000 Arkansas residents. The state has to first get approval from the federal government before making significant changes, because the state provides 10 percent of the funding and the federal government provides 90 percent.
People are eligible for ARHOME if their income is less than 138 percent of the federal poverty level. This year, the poverty level is $30,000 for a family of four and $14,580 for an individual.
Arkansas Medicaid officials are seeking authority to focus on the most poor of the ARHOME recipients, the people whose income is only 20 percent of the poverty level. The Department will assign them a “success coach” if they are not on track toward meeting certain requirements of the ARHOME program.
Success coaches will develop an individual plan to help them meet their healthrelated needs. If they still do not engage in taking care of their lives and their health, after three months they will be moved from ARHOME to the traditional Medicaid program. There is an incentive to take advantage of the opportunities made available through the success coach because many people consider ARHOME care to be better than traditional Medicaid.
In the ARHOME program, the government buys private health insurance for the recipient. Under traditional Medicaid, the government reimburses physicians, hospitals and pharmacies for treating Medicaid patients.
Some physicians don’t accept Medicaid patients because the reimbursement rates are less than they get from private health insurance companies.
Another change sought by state officials is in how to gauge whether or not recipients are complying with requirements to work, volunteer or continue their education. State officials say the goal is to simplify the process so that recipients don’t have to fill out paperwork to prove that they spent the required amount of time looking for work or attending class.
Instead, ARHOME officials will rely on computer data to track whether recipients are working toward self-reliance. For example, if they have taxable income it can be assumed that they have a job. The amount of income will indicate whether they work part-time or full-time.
If they get food stamps, it’s assumed they’re complying with work requirements and if they’re enrolled in adult education, it’s presumed they are taking classes. If they live with someone who has a disability, or with a dependent child or an elderly person, it is presumed that they are caregivers.
ARHOME puts a special focus on helping the most vulnerable, such as residents of rural areas with mental health problems, veterans, young people who have been incarcerated or who have lived in foster homes and pregnant women.
The Human Services Department will train 100 existing employees to be success coaches, and another ten employees to be supervisors.
More than 1.1 million Arkansas residents qualified for Medicaid services earlier this year, but state officials are trying to lower than number by requiring them to re-apply for eligibility.
This fiscal year the program will cost an estimated $9.7 billion, with the federal government paying $7.8 billion and Arkansas providing almost $1.9 billion in matching funds.
