Legislative Update: Feb. 20
Arkansas is changing the eligibility requirements for people who are enrolled in ARHOME, a category of Medicaid the program. Beginning next year they will have to work, volunteer in their community or continue their education in order to continue receiving benefits.
The state must first get approval from the federal government, which pays for 90 percent of the cost of ARHOME. The state pays 10 percent.
The governor and top officials at the state Department of Human Services expressed confidence that the federal government would approve the change. They also are confident that if the work requirement is challenged in federal court, it would be upheld.
This recent work requirement is different from one that was challenged and struck down in court in 2019. The previous requirement caused about 18,000 people to lose Medicaid coverage because they failed to work or seek employment.
The new work requirement will not drop people from the Medicaid rolls. Instead, people who do not work will be transferred to a different category of Medicaid with fewer benefits.
About 345,000 people are enrolled in ARHOME, which the legislature created with Act 530 of 2021. The program is for people with incomes below 138 percent of the federal poverty level, which for an individual is less than $18,000 a year.
The state buys private health insurance for people in ARHOME. A focus is to improve the overall health of people who are particularly vulnerable, such as women with high risk pregnancies. Also, ARHOME has programs for residents of rural areas who have a history of substance abuse or mental illness, and young people who have been in foster care or juvenile detention.
The private insurance that ARHOME provides will cover the costs of mental health treatment and social services that traditional Medicaid does not cover. If someone enrolled in ARHOME is dropped for failure to work, he or she would still be covered by traditional Medicaid.
The fact that enrollees won’t completely lose Medicaid coverage makes the new work requirement distinct from the previous one. Also, it’s the reason state officials are confident the federal government will approve it, and why it would withstand a legal challenge.
ARHOME is one category within the state’s traditional Medicaid program, which provides coverage for more than a million Arkansas residents. Medicaid pays for long term care for senior citizens. It pays for residential care and community services for people with disabilities. It pays for doctor visits and hospital stays for low-income families.
The end of the Covid-19 pandemic will greatly affect Medicaid programs throughout the United States. During the pandemic, the state received extra Medicaid funding from the federal government, but at the same time the state was limited in its ability to remove people from its rolls.
The Arkansas Department of Human Services has already begun preparing for the expected official declaration of the end of the public health emergency. People enrolled in Medicaid should expect to receive letters asking them to submit updated information about their income, so that DHS can determine whether or not they remain eligible.
The family income threshold is higher for children than for adults. It can happen that parents are dropped from Medicaid because they get a job or a raise, but at the same time their children can remain eligible for ARKids First or other Medicaid programs.
