Arkansas will not, for the time being, impose cost-sharing on Medicaid expansion beneficiaries below the federal poverty level.
The state won a federal waiver in 2013 to use funding available under the Affordable Care Act to help residents earning up to 138% of the poverty level buy private plans on the insurance exchange rather than enroll in traditional Medicaid.
At the end of 2014, the Obama administration allowed Arkansas to mandate that all beneficiaries in the private-option plans make monthly contributions to health independence accounts, a version of health savings accounts.
Under the waiver, those making between 50% and 100% of the federal poverty level ($11,925 to $23,850 for a family of four) were expected to contribute $5 a month to the accounts. Those between 100% to 138% of the poverty level were to pay between $10 to $25 monthly, depending on income. Of the roughly 190,000 people in the private-plan option, 80% are below 100% of the federal poverty level.
Newly elected Republican Gov. Asa Hutchinson quietly altered the plan months ago, allowing cost-sharing for people above poverty to move forward, but canceling plans to impose it on poorer enrollees.
“We now know that the private option as it exists today will be replaced,” said Amy Webb, spokeswoman for the Arkansas Department of Human Services. “We felt that it was not prudent to create this new piece for this population if we were just going to change it a year from now. We'd rather take a step back, look at all the scenarios and then move forward with a plan that the Legislature and governor believes is best.” The waiver for the plans ends Dec. 31, 2016.