- Associated Press - Monday, January 4, 2016

LITTLE ROCK, Ark. (AP) - Arkansas Gov. Asa Hutchinson wants to overhaul the state’s hybrid Medicaid expansion by requiring some participants to pay premiums, imposing a restriction on beneficiaries’ assets and adding other limits, the Republican governor told federal officials in a letter released Monday.

Hutchinson detailed the changes he wants to make to the state’s “private option,” which uses federal funds to purchase private insurance for low-income residents. More than 200,000 people are receiving coverage through the program, which was created in 2013 as an alternative to expanding Medicaid under the federal health law.

“I will be requesting key changes to ensure that Arkansas Medicaid promotes personal responsibility, incentivizes work and ensures program integrity,” Hutchinson wrote in a letter dated Dec. 29 to U.S. Health and Human Services Secretary Sylvia Burwell.

Hutchinson spokesman J.R. Davis said the governor plans to meet within the next month with Burwell in Washington about the proposed changes, though a final date has not been set. Hutchinson has said he plans to call a special legislative session later this year to take up any potential changes to the program after his negotiations with Burwell.

The changes listed in Hutchinson’s letter and an attached application outline proposals the governor has already made over the past several months. They include a proposal to require those on the program making more than 100 percent of the federal poverty level to pay premiums and requiring participants to be referred to workforce training.



Hutchinson also wrote that premiums should be considered for those making more than 50 percent of the federal poverty level but said they should be waived if those participants meet requirements aimed at promoting health such as undergoing a wellness exam.

The governor also proposed restrictions on coverage or premiums for beneficiaries with “substantial” assets, such as a home worth hundreds of thousands of dollars.

In addition, Hutchinson wants to require participants to enroll in employer-based insurance if available, with the program paying their premiums and co-pays. Hutchinson, who has proposed renaming the program “Arkansas Works,” said in the letter he will submit an application for the changes this spring.

The hybrid expansion has sharply divided Republicans since it was created in 2013. Democrats have overwhelmingly supported the program in the past but have expressed concerns about some of the restrictions Hutchinson is seeking.

A legislative panel Hutchinson formed to look at the private option’s future last month endorsed Hutchinson’s efforts to negotiate changes in the program. The panel has said it’ll issue recommendations on where to find the $50 million to $60 million in annual Medicaid savings Hutchinson said the state will need once it has to pay for its share of the expanded coverage’s cost.

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Follow Andrew DeMillo on Twitter at www.twitter.com/ademillo

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