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Arkansas and Iowa, two GOP-led states, have received approval for customized options for Medicaid expansion that include cost-sharing provisions for beneficiaries.
Arkansas and Iowa, two GOP-led states, have received approval for customized Medicaid expansion optins that include cost-sharing provisions for beneficiaries.
The Centers for Medicare and Medicaid Services (CMS) sent letters to both states on December 30 indicating acceptance of waivers to the suggested model.
In the Arkansas case, CMS has approved the state’s request to allow beneficiaries of Medicaid to deposit between $5 and $25 per month into a health savings plan depending on income. Beneficiaries who fail to contribute will not lose coverage, CMS noted.
Arkansas received approval for a customized expansion plan in September 2013, but amended that request in September, 2014 to include cost-sharing for beneficiaries, according to the Kaiser Family Fund.
According to the CMS letter, enrollees under 50% of the federal poverty level (FPL) will not be required to make a deposit. Those earning more than 50% and up to 100% of the FPL will be required to contribute $5 a month to a health spending account (HSA); those earning more than 100% and up to 115% will be required to deposit $15 a month into an HSA; those earning more than 115% and up to 129% will be required to deposit $17.50; and those earning more than 129% and up to to 133% will be required to deposit $25.
Arkansas experienced a 22% drop in its uninsurance rate following the implementation of Medicaid expansion in 2013 – the largest drop of any state in the country, according to a Gallup poll.
In Iowa, which received approval in December, 2013 for its customized expansion option, CMS approved $5 monthly contributions for premiums for households with incomes from 50% to 100% of the FPL, and $10 per month for households with incomes from 101% to 133% of the FPL. As with the Arkansas plan, beneficiaries who fail to contribute will not lose coverage, according to the letter.
By mid-2014, Iowa had experienced a 10.4% drop in the uninsurance rate due to Medicaid expansion, according to the Gallup poll.
Twenty-eight states including the District of Columbia have received approval from CMS to expand Medicaid since the U.S Supreme Court decision in June 2012 made expansion a state option
As of December 2014, four of those states have implemented a customized expansion option: Pennsylvania, Michigan, Arkansas, and Iowa. CMS is currently reviewing a waiver proposal for Indiana, while Utah has received preliminary approval for its waiver proposal.