Medicaid expansion

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The Affordable Care Act established an expansion of Medicaid eligibility levels. In 2014 states can cover low-income adults between 19 and 64 and increase the eligibility level to 133% of the federal poverty level. All of the cost of covering the newly eligible Medicaid recipients will be covered by the federal government from 2014 to 2016, with the federal payment rate decreasing over subsequent years. The following table shows the percent of the reimbursement for newly eligible Medicaid recipients that will be covered by the federal government. (Arkansas's FY2013 base rate is 70.17%.)

2014	100%
2015	100%
2016	100%
2017	95%
2018	94%
2019	93%
2020	90%

Additionally Medicaid reimbursement to primary care physicians will increase, with the increase in costs covered at 100% by the federal government.

In June 2012, the U.S. Supreme Court upheld the constitutionality of the Medicaid expansion, but said the expansion must be offered to states as an option, not a mandate.

Arkansas's implementation

During the 2013 legislative session, the Arkansas General Assembly passed Acts 1497 and 1498, twin measures known as the Health Care Independence Act. These measures established the state's intention to apply for a federal waiver that would allow the state to use Medicaid funding to pay for private health insurance for individuals with household incomes up to 138% of the federal poverty level. The state submitted the waiver application in August 2013, and the federal government approved the plan the following September.

Federal Documents

HHS: States must expand Medicaid to 133% FPL to receive 100% federal match

Arkansas Documents

Act 1497 of 2013: Health Care Independence Act (Private Option) PDF
Act 1498 of 2013: Health Care Independence Act (Private Option) PDF
Arkansas's Draft Medicaid Waiver for "Private Option" PDF
Arkansas's Final Medicaid Waiver for "Private Option" PDF
Estimated impact of Medicaid expansion on Arkansas state budget Excel
This spreadsheet, drafted by Arkansas Medicaid, provides the estimated number of enrollees as well as estimated annual costs/savings if the state opts to expand Medicaid.