Arkansas: State Releases Medicaid Expansion Waiver Extension for Public Comment

The Department of Human Services released a draft 1115 waiver extension application to implement Arkansas Works, a plan to extend and reform the State's Medicaid expansion, for a 30-day public comment period prior to submitting the request to CMS. The program, which the Legislature authorized last month, seeks to institute mandatory premium assistance for beneficiaries with access to cost-effective employer-sponsored insurance, premiums for beneficiaries with incomes above 100% of FPL, an incentive system to encourage premium payment and healthy behaviors, and referrals for job training for individuals with no income. Arkansas plans to submit the waiver extension request to CMS this summer which, if approved, will take effect January 2017.

California: Medicaid Now Available for Undocumented Children

Undocumented children under age 19 are newly eligible for comprehensive Medi-Cal coverage in California, as implementation launches for "Health for All Kids," a law passed last October. State officials expect approximately 185,000 of the 250,000 total eligible undocumented children to enroll this year, including 121,000 that will be automatically transferred from a limited benefit package with only emergency care coverage. Governor Jerry Brown (D) allocated $188 million for the State-funded coverage expansion in his recently updated budget proposal.

Kansas: Governor Cuts $56 Million From Medicaid Budget

Governor Sam Brownback (R) announced that more than $56 million of his total $97 million in State spending cuts will come from Medicaid, triggering a loss of $72 million in federal Medicaid matching funds. Approximately two-thirds of the cuts will stem from reducing many KanCare (the State's privatized Medicaid program) provider reimbursement rates by 4%, excluding home-based providers for the disabled and the State's 95 rural critical access hospitals. The remaining cuts will be distributed throughout other areas of the Medicaid program, including a 4% profit margin reduction for the three managed care organizations administering the KanCare program.

Oklahoma: Medicaid Budget and Potential Provider Rate Cuts Remain in Limbo

The Oklahoma Health Care Authority's (OHCA) Board postponed voting on a 25% provider rate cut because the Legislature has not yet finalized Medicaid's State appropriation. OHCA CEO Nico Gomez proposed the cuts in March due to budget shortfall concerns, and later proposed the "Medicaid Rebalancing Act of 2020" as an alternative to the rate cuts. The Act, which has now expired in the Legislature, would have generated funding through an increase in the cigarette tax, extended the State's premium assistance program to individuals earning up to 133% of FPL, and transitioned some women and children currently enrolled in Medicaid into the Marketplace. House Speaker Jeff Hickman is reported to have said he does not think 25% provider rate reductions will be necessary to help fill the State's $1.3 billion budget hole.

Virginia: Governor Vetoes Budget Restriction on Expanding Medicaid

Governor Terry McAuliffe (D) signed the State's 2016-2018 biannual budget and line-item-vetoed a provision that would have invalidated all State appropriations if the governor expanded Medicaid without the permission of the State's General Assembly. The Governor's spokesman said the Governor is not planning to expand Medicaid unilaterally, but that the administration continues to assess opportunities to "bring this money home." House Speaker William J. Howell (R) contested the validity of the line-item veto, stating that "the Governor cannot veto conditions attached to appropriations without vetoing the appropriation" itself.