Dive Brief:
- The unique Medicaid expansion underway in Arkansas—a "private option" plan using Medicaid funds to buy private health coverage for eligible consumers—could depend on the results of two state Senate races, as opposing members in both houses are otherwise deadlocked.
- State legislators who favor the private option note that the new coverage, which now reaches 200,000 state residents, is funneling money to struggling healthcare providers.
- Opponents, meanwhile, suggest that the federal reimbursement, which pays 100% of the cost for the first three years of the expansion, may not actually last. They also note that a GAO report from this fall found that traditional Medicaid would have cost less than the state's current model.
Dive Insight:
The battle over Arkansas' private option model is likely to be decided along purely partisan lines, with the numbers being cited by supporters and opponents of this Medicaid expansion differing wildly.
For example, opponents of the private option Medicaid expansion argue that it is a significantly more expensive approach to Medicaid expansion than traditional Medicaid, They argue that because the ACA requires the state to buy wraparound coverage protecting beneficiaries from large out-of-pocket expenses, the real cost of the private option is much higher than it appears. Based on these financial issues, not to mention philosophical differences, the state's Republicans are largely dead-set against the expansion.
Supporters, meanwhile, have their own set of numbers. For example, Arkansas medical director Andy Allison has completed an analysis concluding that implementing the expansion would save the state money overall, particularly by cutting back on the tens of millions of dollars the state spends per year paying for care for the uninsured. He also notes that nearly $1 billion in new federal money will be paid to local healthcare providers. These are the numbers Democrats have tucked under their arm.
While these number may be debated, it seems unlikely that they'll change minds. The bottom line appears to be that if Democrats don't win two contested seats, the private option may be finished.
Want to read more? You may enjoy this story about whether the private option hurts or helps providers.