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State Capitol Week in Review – December 31, 2021

LITTLE ROCK – When the new year begins, the Arkansas Works program will have a new name and will operate under new rules.

ARHOME is the new Medicaid program. Unlike the previous program, it will focus on specific groups, such as pregnant women, residents of rural areas who suffer from mental illness or who have a history of drug abuse, people with chronic disease and young people who are veterans or who lived in foster homes.

Their health insurance carriers will have to meet specific goals. If not, they will have to follow an action plan designed to improve performance, or face financial penalties in 2023. Earlier in December a panel of legislators and health officials approved a set of goals that medical providers must reach.

Arkansas Works was the name of the state’s Medicaid expansion plan. It covered 319,000 people between the ages of 19 and 64 last year. They are not enrolled in Medicare and they earn less than 138 percent of the federal poverty level, but more than 16 percent.

About 10 years ago people in that income range earned too much money to qualify for traditional Medicaid, which provides government-subsidized health coverage for low-income families. They became eligible under the national Affordable Care Act, which every state implemented in its own way.

Rather than simply expand the eligibility criteria for traditional Medicaid, Arkansas covered the new group of enrollees under an innovative plan that relies on private health insurance.

At first it was called the private option. It became known as Arkansas Works after the legislature changed the rules to require recipients to work, or look for work, in order to qualify.

Other states also had work requirements too, but they all were stricken by the federal courts after legal challenges.

Like the private option and Arkansas Works, ARHOME will use Medicaid funding to purchase private health insurance for individuals who qualify financially.

In response to the federal courts striking down the work requirement, ARHOME will have a new incentive to encourage recipients to look for a job. If participants fail to look for work, they will be transferred out of private insurance and into the traditional Medicaid program, which doesn’t provide as many benefits.

Health officials are excited about the maternal care that ARHOME will provide women and their newborn children. Medical teams will have incentives to identify and care for women whose pregnancies are high risk, through home visits during the pregnancies and until the newborn is two years old.

The expectation is that the home visits will reduce infant mortality, and increase the percentage of infants who are fully immunized against chronic and deadly diseases.

Officials at the Department of Human Services count on ARHOME being more financially efficient. Last fiscal year, Arkansas Works spent $2.46 billion. Of that amount, 90 percent came from the federal government and 10 percent was appropriated by state government.

Improving the health of high-risk populations should hold down the cost of providing medical coverage through Medicaid.

Parts of ARHOME are designed to lift young people out of poverty, which would benefit the state’s long-term fiscal condition.


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