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What’s All This Talk About Arkansas? . Progressive States Network April 22, 2013 Alan Weil Executive Director National Academy for State Health Policy. Arkansas Plan. Medicaid expansion Use premium assistance through the health insurance exchange Seek to make mandatory

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What s all this talk about arkansas

What’s All This Talk About Arkansas?

Progressive States Network

April 22, 2013

Alan WeilExecutive DirectorNational Academy for State Health Policy


Arkansas plan
Arkansas Plan

  • Medicaid expansion

  • Use premium assistance through the health insurance exchange

  • Seek to make mandatory

  • Seek to have the exchange coverage meet all the requirements the state has under Medicaid


What is medicaid premium assistance
What is Medicaid Premium Assistance?

  • Long-standing set of programs to use private insurance as the first payer

  • Limited because:

    • Most on Medicaid don’t have an offer of employer-sponsored insurance

    • Often only cost-effective for those with significant health needs

    • Administratively complex

    • Wrap benefits or get a waiver


Aca changes feasibility of premium assistance
ACA Changes Feasibility of Premium Assistance

  • Individual insurance becomes viable

    • Essential health benefits

    • Rating restrictions

    • Health insurance exchange

  • Benefits are closely (not perfectly) aligned

  • Administration much simpler


The bottom line
The Bottom Line

  • Arkansas plan makes a conversation possible primarily for political reasons

  • Cost-effectiveness is uncertain

  • CMS flexibility is uncertain

  • But if you can make it work it has potential

    • Reduced churn

    • Consolidated purchasing

    • Better access?

  • Don’t forget – it is still a Medicaid expansion


Selected resources
Selected Resources

  • Once in A Weil Blog: Much Ado about Arkansas and Where Does the Arkansas Bandwagon Lead?

  • HHS FAQs on Medicaid and the Affordable Care Act: Premium Assistance Health Reform GPS

  • Health Reform GPS: Update- Using Medicaid to Provide Premium Assistance for Exchange Coverage

  • Financial Impact of Arkansas’ Private Option Plan for Insurance Premium Assistance

  • State Health Reform Assistance Network: Purchasing Coverage for Medicaid Beneficiaries in the Exchange: A Review of the Premium Assistance Option

  • StateRefor(u)m Arkansas Documents


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