State Eyes Arkansas Plan As Model For Medicaid Expansion

Does Arkansas have a health care solution that would work in Alaska? The state’s Health and Social Services Commissioner, Bill Streur, is looking into that. Arkansas wants to use federal Medicaid expansion money under the Affordable Care Act to enroll people in private plans on its health insurance exchange.

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It’s called the “private option” for Medicaid expansion. Instead of enrolling low-income, uninsured people in Medicaid, Arkansas would buy them insurance plans on the state’s health insurance exchange. Alaska Commissioner Bill Streur thinks it makes a lot of sense:

“It’s an intriguing model. If we can get more insurance through this, we ought to at least be in open dialogue with the federal government on this.”

Streur says he hasn’t spoken with Governor Parnell about the idea. But he says Arkansas’s plan addresses Parnell’s biggest problem with the expansion- that it leaves the state vulnerable to paying huge sums for the Medicaid program down the road. Parnell spoke with APRN about the issue in January:

“My concern is really that we not expand a program that the federal government can cut its funding to, but require us to continue and take over the federal share.”

Commissioner Streur says the Arkansas plan makes it easy for states to pull out of the expansion if that happens.

The Medicaid expansion starts in January, with the federal government paying for 100% of the program for the first three years. The federal government hasn’t approved the Arkansas model, but has worked with the state to draft the necessary waiver application. The Health and Human Services department has said it will consider approving a limited number of Arkansas style plans as demonstration projects. And Alaska isn’t the only state closely watching what happens in Arkansas, according to Matt Salo, executive director of the National Association of Medicaid Directors:

“A lot of states are looking at this and saying if this really works in Arkansas, we’d like to try this.”

Salo says the Medicaid expansion would bring a lot of federal money into states. But he says the decision on whether to expand the program is a delicate one for many Republican Governors:

“A significant portion of them are amenable to expanding coverage if they can find a more politically or philosophically preferable approach, something that looks more like the private sector than it does a big government expansion.”

The Medicaid expansion would offer coverage to about 50,000 uninsured, low-income Alaskans. Susan Johnson is the regional director for the federal Department of Health and Human Services. She says the government is very open to negotiating with Alaska officials about what type of Medicaid expansion would work in the state:

“It’s not just, I want an Arkansas model, it’s what is best for the state itself… So Arkansas may come up with elements that Alaska would like, but there would be particular elements for Alaska that will be different from Arkansas. It’s just that we need to start that conversation.”

Commissioner Streur says he hopes to deliver a briefing to Governor Parnell about the Medicaid expansion decision in October.

This story is part of a reporting partnership between APRN, NPR and Kaiser Health News.



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Annie Feidt is the broadcast managing editor at Alaska Public Media. Reach her Read more about Anniehere

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