“As governor, I will accept the continued expansion dollars from the federal government if we can achieve the (Medicaid) waivers that are needed,” Hutchinson told a joint meeting of the Health Reform Legislative Task Force and the Governor’s Advisory Council on Medicaid Reform.
Hutchinson said he favors an approach that controls costs, provides incentives for people to work, strengthens employer-based insurance, promotes healthy behavior and responsibility, allows flexibility for the state and continues to provide some kind of coverage for the more than 200,000 Arkansans enrolled in the Medicaid expansion program known as the private option.
He outlined a “potential plan” with the following seven elements, some of which would require Medicaid waivers:
• Mandate participation in employer-sponsored insurance when it is available and provide premium assistance to workers.
• Require people earning more than 100 percent of the federal poverty level to pay premiums capped at 2 percent of household income. Currently, the private option subsidizes private health insurance for Arkansans earning up to 138 percent of the federal poverty level, at no cost to the participants.
• Require referrals to work training for the unemployed and under-employed.
• Eliminate non-emergency medical transportation coverage.
• Restrict private-market coverage to working people and make the income requirement adjustable rather than offering private-market coverage to all whose income is 0-138 percent of the federal poverty level. People whose income level is below the new cutoff would be enrolled in traditional Medicaid.
• Limit the state’s share of Medicaid expenditures to pre-private option dollars plus inflation, which Hutchinson said would require eventually finding $50 million to $60 million in savings per year in Medicaid and the Medicaid expansion.
• Strengthen program integrity to ensure that all who are receiving benefits are qualified.
