JONESBORO — The state’s newest approach to Medicaid expansion that Gov. Asa Hutchinson announced Tuesday will likely prevent many of the people who need the coverage the most from getting it, said Kevin De Liban, director of advocacy for Jonesboro-based Legal Aid of Arkansas.
Legal Aid of Arkansas has successfully fought the state’s Medicaid decisions in the courts, including a work requirement that a federal appeals court rejected during the Donald Trump administration.
The 85-page plan called Arkansas Health and Opportunity for Me (ARHOME) was released June 11, opening the public comment period in advance of officially submitting the plan to the federal Center for Medical Services. Implementation of the program would require a federal waiver of normal Medicaid rules to provide private insurance coverage to people who earn up to 138 percent of the poverty rate.
De Liban on Thursday criticized the state’s short time frame, which allowed only five business days to digest the complicated program; public hearings by way of webinars are scheduled for Monday and Tuesday, and written comments will be accepted through July 12.
“So many of our clients work as food servers, cashiers, caregivers, poultry workers, landscapers, housekeepers and maintenance workers,” De Liben said. “Most of their employers don’t offer health insurance, or, even if they do, the insurance isn’t affordable given our clients’ relatively low wages, inconsistent hours and other immediate expenses.”
About 320,000 people are enrolled in Arkansas Works, the current version of expanded Medicaid. The work requirement in Arkansas Works was struck down by the Supreme Court after Legal Aid joined the National Health Law Program and Southern Poverty Law Center in the lawsuit.
People whose income is under the poverty line aren’t affected. At 138 percent of the poverty rate a single person with income up to $17,774 or a couple earning $24,040 would be eligible for the federally supplemented private health insurance coverage. For a family of four, the income limit is $36,570.
De Liben said Arkansas Works was bad for poor people, but ARHOME appears to be worse.
“Hiking premiums and making people pay more for services through co-pays is again going to limit people’s access to and use of Medicaid, without a doubt,” De Liben told The Sun. “I think that’s the goal.”
Medicaid law provides for retroactive eligibility for three months before the date someone applies for Medicaid as long as the person met the eligibility requirement during that time. The ARHOME proposal seeks permission to cut the retroactive date to one month prior.
De Liben gave an example of one person who had a middle income job.
“A single father raising his two young boys. The income from his job was above the income limits for Medicaid,” De Liben said. “He then fell deathly ill, was in the hospital for several weeks, and then was home sick after that.
“The illness caused him to stop working for several months. During that time, he incurred over $60,000 in medical bills. His loss of income meant that he now qualified for Medicaid, but, because of health problems and lack of knowledge, he didn’t actually apply for Medicaid until a couple months later. Without retroactive coverage, he would have had a huge debt burdening him and his children for years.”
De Liben said everyone should have access to health care, regardless of income.
“But beyond that, we saw in the pandemic the fragility of so many people’s lives and stability,” De Liben said. A strong Medicaid program is needed in such times, he said.
Monday’s public hearing will be from 12 to 1 p.m. before the state Behavioral Health Planning and Advisory Council (Webinar ID Number 898 5206 7259): https://us02web.zoom.us/j/89852067259
Tuesday’s hearing will be at 4 p.m. Webinar ID Number 892 5110 0312): https://us02web.zoom.us/j/89251100312
Written commends may be sent by email to: ORP@dhs.arkansas.gov