Arkansas: Report Recommends Continuing Medicaid Expansion Program

report presented to the Arkansas Health Reform Legislative Task Force supports the continuation of the State's Medicaid expansion program (known as the "Private Option," which uses Medicaid funds to purchase qualified health plan coverage for eligible individuals through the State's Marketplace) with changes that emphasize personal responsibility, wellness, and accountability. The report, submitted by the task force’s consultant, the Stephen Group, confirms preliminary projections released in August that expansion will have a net positive impact of $438 million on State funds between 2017 and 2021. The report also recommends specific program reforms, including: implementing a mandatory premium assistance program for employer-sponsored insurance; enhancing cost sharing for beneficiaries with substantial assets; mandating a work referral program for beneficiaries who are not meeting work standards; and authorizing beneficiaries to be locked out of the program for six months in certain circumstances. The report addresses other health reform issues, such as a potential 1332 State Innovation Waiver for the State's Small Business Health Options Program Marketplace and options for reforming the State's traditional Medicaid program. The task force is expected to make its final recommendations in December.

Arkansas: Director of Human Services Resigns

Department of Human Services Director John Selig announced that he will resign at the end of the year and move to the private sector, reports Arkansas News. Selig has worked in State government for 27 years, previously serving in directorship roles for behavioral health services and in-home health services. Most recently, Selig led the implementation of the State's Private Option program for Medicaid expansion. A replacement has not been named.

Connecticut: Governor Restores $14 Million in Medicaid Funding to Small Hospitals

Connecticut Governor Dannel Malloy (D) announced plans to restore $14.1 million in funding to six independent hospitals several weeks after he cut $63 million in hospital Medicaid payments from the State’s budget. The cuts, which would have totaled more than $190 million with the added loss of federal matching funds, were met with harsh criticism from State legislators and hospital executives who continue to call for a Special Session to review the cuts and to restore full hospital funding. Restored funds are being reallocated from supplemental payment funds for the State's larger hospital groups.

Iowa: Department of Human Services Signs Medicaid Managed Care Contracts

As part of the State’s transition to Medicaid managed care for the majority of its 560,000 enrollees, Iowa’s Department of Human Services (DHS) signed contracts last week with four managed care organizations selected through competitive bidding in August: Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley, and WellCare of Iowa. DHS is moving forward with the transition to managed care on January 1, 2016, pending federal approval, despite protest from some State legislators over the pace of the transition and from some carriers that were not selected over the bidding process.

South Dakota: Governor Establishes Coalition to Study Medicaid Expansion

Governor Dennis Daugaard (R) has convened a group of State, health, and tribal officials, collectively called the Health Care Solutions Coalition, to study options for paying for the State’s share of a potential Medicaid expansion program, reports the Associated Press. The Governor is interested in offsetting the cost of expansion in part by increasing utilization rates of Indian Health Services, which are fully funded by the federal government. The Governor’s office reported that HHS Secretary Burwell expressed openness to the plan during a recent meeting.

Utah: Future of Medicaid Expansion Plan Is Uncertain Following First Public Hearing

The Utah Legislature’s Health Reform Task Force convened for the first public discussion of the recently-revealed “UtahAccess+” Medicaid expansion plan. While many advocates and supporters were present, the plan was met with fierce opposition from most of the 16 provider groups present at the meeting, who would face $50 million in collective special taxes and fees each year to support the implementation of UtahAccess+. A few provider groups, including the Utah Hospital Association, expressed general support for expansion but were hesitant to support the proposed taxes and fees. Significant public confusion remains over the sparse plan details that were released, which indicate that medically frail individuals would be enrolled in traditional Medicaid plans, while most low-income Utahns up to 138% of the federal poverty level (FPL) would be offered subsidies to help pay for private insurance. Those between 100%-138% of the FPL would be charged monthly premiums and copays. The House GOP caucus is deciding whether to hold a special session later this month to vote on the expansion plan, though Governor Gary Herbert’s (R) administration is fearful that support may be insufficient to move forward.

Wyoming: Budget Shortfall May Prompt Consideration of Medicaid Expansion

Governor Matt Mead (R) announced that Wyoming will likely face a $100 million to $200 million budget shortfall in the coming fiscal year, which could prompt legislators to reconsider expanding Medicaid in order to draw down federal funds to implement expansion. Governor Mead has instructed the Wyoming Department of Health to draft two budgets proposals, one with federal Medicaid expansion funds and one without, for lawmakers to consider during their budget session in early 2016, according to the Associated Press. However, Medicaid expansion attempts failed during Wyoming's previous legislative session, and opposition remains particularly strong in the House.