HJAR Sep/Oct 2020

36 SEP / OCT 2020 I  HEALTHCARE JOURNAL OF ARKANSAS POLICY THE GENERAL ASSEMBLY has renewed funding for the program every year, a significant accomplishment given the three-fourths vote of support required in both chambers. State lawmakers will decide on the program, now known as Arkansas Works, again in the 2021 session, but this time the decision is different because it is not just a question of funding. The legislation that authorized the program will expire at the end of 2021, so Arkansas Works will require new authorizing legislation. This could mean the addition of new features like those we have seen previously, such as premium and work requirements, the latter of which likely will still be meandering through the federal courts. It could also mean a reimagining of the entire program. State reauthorization and renewal of funding are not the only hurdles the program faces. The federal waiver under which the program operates also expires at the end of 2021. Arkansas won’t know until after November what administration it will COLUMN POLICY be submitting a waiver renewal request to next year. TheAffordable CareAct itself faces a legal challenge that the U.S. Supreme Court has agreed to hear in its term that begins in October. A decision could come this fall, but is more likely to arrive in 2021. At this writing, Arkansas and Louisiana are still the only southern states to expand Medicaid. Oklahoma voted for expansion in June, making it the first state to decide to expand during the COVID-19 pandemic, but the program will not be implemented until next year. In part, because of its lack of Medicaid expansion, Oklahoma is one of only two states where the uninsured rate is still above 14 percent, according to U.S. Census data. The pandemic was among the factors that supporters in Oklahoma cited as arguments for expansion. Medicaid expansion had already proven its value in Arkansas before the pandemic. The programhas extended health insurance coverage to nearly 300,000 people, increased insurance market competition Since the Arkansas General Assembly first decided to expand Medicaid under the federal Affordable Care Act in 2013, the reasons it was a good decision for Arkansas have kept growing – one of the most notable examples being the help that Medicaid expansion has provided to Arkansans in dire need of medical services during the COVID-19 pandemic. ARKANSAS WORKS: A Crucial Safety Net in Pandemic, It Faces Hurdles in 2021