Governor Asa Hutchinson called the effort to remove ineligible persons from Arkansas Works (Obamacare Medicaid Expansion) “a model for containing costs and eliminating waste in state government.” The Governor said his Department of Human Services “combined common-sense fact-finding with new technology to reduce our load by 80,000 cases.”[i]
This prompted state Senator John Cooper to write a letter to the editor of the Jonesboro Sun to declare the news as vindication for his vote for the big government program. He also attacked conservative opponents of the Obamacare program who he claimed came from “a small tea party motivated segment.” Further, he warned voters against the supposedly “extreme” legislators. (All conservatives look “extreme” to big government politicians.
To pat themselves on the back, Hutchinson and Cooper turn a blind eye to the disastrous record of Obamacare Medicaid Expansion in Arkansas. While bragging on making a step forward in verifying eligibility enrollees, they ignore the Hutchinson administration failures that delayed verification and allowed so many ineligible people to be on the Medicaid roll. They ignored how much taxpayer money has been wasted on the program through mismanagement.
Years Passed While Arkansas Made Money on Ineligible Enrollees
Arkansas Works was passed in 2016, but the law was little more than a name change from “Private Option”. Under either name it is “Obamacare Medicaid Expansion” which provides health care coverage to low income individuals. It turned out that the group covered under the program is primarily able-bodied working age adults who do not work.
Four years have passed since the Arkansas’ Obamacare program became operational in 2014. Meanwhile the number of ineligible people being enrolled was allowed to grow.
Eligibility verification appears to have been a low priority during the first three years of the program when the state was making money from a bloated program. In 2014, 2015 and 2016 the more people who were enrolled, the more money Arkansas could put in the State Treasury. The federal government was paying all the cost of the Obamacare Medicaid Expansion program and Arkansas was making money by collecting an insurance premium tax for each person enrolled in the program. In October 2015, Conduit For Action warned our federal tax dollars were being siphoned off by the Hutchinson administration. (See article: Arkansas is making money by allowing fraudulent enrollees in the Private Option.)
When Arkansas had to start paying part of the cost of Obamacare Medicaid Expansion DHS had a verification backlog of more than 140,000 Medicaid eligibility cases. How bad did DHS let it get? Almost 60% of the backlog were found not to be eligible.
By the way, on those 80,000 removed from the program … a premium tax would have been collected.
The Governor cited common-sense fact-finding along with new technology (a computer program) with reducing the rolls. First, a little “common-sense fact finding” would helped reduce the rolls in years past. Second, don’t you wonder why it took years to get the computer program?
Hutchinson’s DHS botched the effort to implement a computer system. DHS spent millions of dollars on a computer verification system that didn’t work. DHS paid $32 million to a contractor that DHS eventually had to fire from the project in 2015. In addition, the estimated cost of the system doubled from $100 million to $200 million. [ii] Wasting millions of dollars on a system that did not work allowed the verification backlog to skyrocket.
MORE MEDICAID EXPANSION PROBLEMS
Where did the money go?
In 2015 DHS admitted it couldn’t account for $43.9 million in Medicaid Funds.[iii] No one said the funds were misused – they just didn’t know where the money was or went. DHS blamed the accounting problem on implementation of Obamacare Medicaid Expansion, not themselves. DHS supposedly didn’t even know about its faulty accounting. The $43.9 million error had to be found by the Division of Legislative Audit.
Asa’s Failed Plan to Have Some Enrollees Pay a Premium
Proponents of Asa’ Arkansas Works lauded a provision requiring some enrollees with more income to contribute $13 a month toward the cost of coverage. How has that worked out? About 62,000 enrollees were supposed to pay the premium but it was recently reported only “about 20 percent of enrollees who are required to pay premiums do so on a regular basis” and the “others owe premiums totaling about $8 million”.[iv]
Will the state be able to collect on this debt? Not likely. Many collection methods are prohibited. The withholding of Arkansas income tax refunds has been cited as the main method for collecting. Remember these are low income enrollees. Most of $8 million (and counting) is likely to remain uncollected debt.
Growth in Spending
The Democrat-Gazette reported spending on Arkansas’ Obamacare Medicaid Expansion program grew by almost 24 percent during the fiscal year that ended June 30, 2017.[v]
Growth in enrollees
Is enrollment in Arkansas Works (Obamacare Medicaid Expansion) shrinking? That is the impression you are supposed to get from the news that enrollment in early January 2017 was 330,000 but as of November 30, 2017 enrollment dropped to 306,849. But, when you realize the reduction amounts to be far less than the 80,000 ineligible enrollees that have been removed, you see the Obamacare program is still growing out of control.
Also remember the program quickly grew beyond Arkansas’s initial estimate of 250,000 being eligible for the program.
Mother, May I?
The Governor is quick to remind everyone he has applied for a federal waiver that would allow Arkanas to remove about 60,000 people from the program (those with income above the poverty level) and would require some others to look for work. This is nothing more than asking the federal government “Mother, May I?”
Even if a waiver were to be granted, expect lawsuits because he is not trying to get a waiver from a federal regulation but from federal law. If you think entitlement advocates would let the law be waived without a serious challenge, think again.
In a statement published Tuesday [12/19/2017], the Center for Budget and Policy Priorities, a research organization in Washington, D.C., focused on reducing poverty and inequality, said limiting eligibility to the poverty level, which Massachusetts has also proposed, wouldn’t support the purpose of the Medicaid program as the law governing Medicaid waivers requires.
“These waiver proposals neither identify any policy that the state would be testing by rolling back coverage for current beneficiaries nor explain how rolling back coverage furthers Medicaid’s objectives,” Jessica Shubel, a senior analyst with the center, wrote.
“Moreover, the one rationale that’s included in both proposals — saving money for the states — is not a permissible use of” authority under Section 1115 of the Social Security Act, which sets requirements for waivers. (Democrat-Gazette 12/20/2017)
A response from the Trump administration was expected months ago and still has not come. Think about it. Asa is trying to get a waiver to support Arkansas’ Obamacare Medicaid Expansion program when the Trump administration is trying to end Obamacare. Maybe Asa should hope the Trump administration delays its response until after the Republican Primary in May so he can still campain on the hoped for waiver instead of the Trump administration rejecting it and having potential candidates exploit another failure.
ASA’ OBMACARE SHIPWRECK
Is the reduction of thousands of indelible enrollees a sign of conservative achievement by the Governor or is it proof the situation was allowed to get out of control under his watch? When we look at the overall record of the program, we see the wasted taxpayer money to be one more among many failures of Hutchinson’s Obamacare Medicaid expansion.
When you go to vote, Senator John Cooper wants you to think about the success of removing 80,000 ineligible enrollees from Arkansas Works (Obamacare Medicaid Expansion). We too want you to think about the 80,000 who received benefits despite being ineligible. We want you to consider the entire record of Asa’ Obamacare Medicaid Expansion. We think you will come to a different conclusion than Cooper, Hutchinson, and other big government politicians.
[i] State Medicaid rolls cut by 2,900, Arkansas Democrat-Gazette, 12/20/2017
[ii] System’s cost up to $200M, legislators told, Arkansas Democrat Gazette, 5/29/2015
[iii] State hazy on $43.9M of Medicaid, Arkansas Democrat Gazette, 6/6/2015
[iv] Insured face tax taps over amounts due; Arkansas Works enrollees behind in paying premiums, Arkansas Democrat-Gazette, 12/19/2017
[v] State’s spending for Medicaid up, Arkansas Democrat Gazette, 10/02/2017