LITTLE ROCK, Arkansas — Consultants hired by Arkansas legislators to review the state's "private option" Medicaid plan recommended Wednesday that the program continue but suggested changes that would move participants into jobs and ensure they are leading healthy lives.
Under its own approach to the federal Affordable Care Act, Arkansas uses federal money to help buy private insurance for poorer residents. It paid consultants at The Stephen Group of New Hampshire to consider what Arkansas should do as it begins paying an increasing share of costs in 2017.
Earlier findings from the consultants projected Arkansas would see a net benefit of $438 million between 2017 and 2021 under the private option. "At the same time, the traditional Medicaid program is growing at an unsustainable pace, displacing other critical services, such as education, public safety and criminal justice," their report Wednesday said.
They recommended moving people out of the private option and moving them "upward on a ladder of opportunity." Their report said recipients should be referred for jobs and that the state should support businesses that hire people into positions that include health insurance coverage.
The state also should require that recipients take part in wellness programs, similar to those in many private businesses. Premiums and co-payments would be assessed to those who don't meet health targets, and people who refuse to take part could be dropped.
"It's the people you serve that we want you to think about," consultant John Stephen said. Rather than just paying providers for their tasks, there should be "better health care outcomes" at the end of the day, he said.
The Health Reform Legislative Task Force met Wednesday to hear the report and ask questions. Additional meetings are set for Oct. 20, Nov. 10 and in December as it works toward an end-of-the-year deadline for recommendations to Gov. Asa Hutchinson and the Legislature on where Arkansas goes next.
"It outlines a clear path forward. It certainly meets my expectations," said Sen. David Sanders, R-Little Rock. "It also meets the expectations that we've heard voiced out of the Legislature and the executive branch. Now it's a question of will. Is there a will to act?"
Stephen said that moving people into jobs means that enrollment in the private option should be temporary. To underscore that, he suggested a new name — T-HIP, or Transitional Health Insurance Program.
"The success of every public assistance program should be measured by how many people are able to move themselves off the aide (sic) and up the ladder of opportunity," a summary of the report said. "This is particularly true for programs for able-bodied adults."
More than 225,000 people are covered by the private option, and the consultants said that 40 percent have no income.
"There is a much larger looming public policy crisis resulting from massive future growth in traditional Medicaid if the state does not reform this program," the report said.
Hutchinson has said he supports keeping the private option if the federal government would let the state impose limits on benefits and eligibility.