Forbes: AR DHS Director Misled Lawmakers On Obamacare Waiver

By Jonathan IngramNic Horton and Josh Archambault Mr. Ingram is Research Director, Mr. Horton is Policy Impact Specialist, and Mr. Archambault is a Senior Fellow at the Foundation for Government Accountability.

Arkansas bureaucrats are wasting millions of dollars providing Medicaid benefits to people no longer eligible for the state’s Obamacare expansion. But is that just the tip of the iceberg?

Last month, internal e-mails from the Arkansas Department of Human Services surfaced, revealing that the state had never bothered to verify that individuals enrolled in Obamacare’s Medicaid expansion were still eligible for benefits. According to data provided by state officials, this is costing taxpayers up to $20 million each and every month.

We previously questioned why the state hadn’t started the redetermination process yet – which should have begun months ago. After all, federal law requires states to verify Medicaid enrollees’ eligibility at least once per year.

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Department of Human Services Director John Selig (Photo: Log Cabin Democrat)

As we reported at the time, state officials contended that they had received a temporary waiver from the Obama administration, allowing them extra time to perform the eligibility checks. But it turns out that no formal waiver ever existed. Worse yet, a recent follow-up letter from the Obama administration may generate more questions than answers.

No Waiver Existed

After news broke that the state wasn’t performing the required eligibility checks, a number of reporters and lawmakers reached out for a copy of that waiver. Such a waiver would be pretty important – without it, Arkansas would be violating federal law.

But according to internal e-mails and other communications, no such waiver actually existed. Questions about the redetermination process sent state officials scrambling for cover.

That cover came on April 27, 2015, when the Obama administration retroactively approved Arkansas’ delay for all redeterminations that should have been conducted in 2014. The letter states:

[The Centers for Medicare and Medicaid Services] is now providing Arkansas with authority under section 1902(e)(14)(A) of the [Social Security Act] to delay eligibility renewals scheduled for January 1, 2014 through December 31, 2014 for 9 months, until October 1, 2014 through September 30, 2015. The state will continue to act on changes in circumstances, including changes in income.

Obama’s Letter Provides More Questions Than Answers

Unfortunately, this letter provides more questions than answers. First, it says that the Obama administration is now providing Arkansas the authority to delay its eligibility redeterminations. Does that mean that Arkansas was operating without that authority prior to April 27th? It certainly seems that way.

The Department of Human Services also contends that this letter allows them to delay all redeterminations until September 2015. But that is not, in fact, what the letter says. The letter allows them to delay redeterminations due in 2014 “for 9 months.” While a redetermination due on December 31, 2014 would not be due until September 2015 under this letter, one originally due on January 1, 2014 was actually due back in October 2014. This means that all redeterminations originally scheduled between January and August of last year should already have been conducted.

But even more worrisome is that the letter limits the delay exclusively to “eligibility renewals scheduled for January 1, 2014 through December 31, 2014.”It provides zero authority to delay redeterminations that should have been scheduled in 2015. So why hasn’t the state conducted the mandatory redeterminations that were due in January, February, March and April?

The Redetermination Process Should Have Begun Months Ago

Regardless of whether or not Arkansas’ actions are approved by Obama, they should be worrisome to taxpayers everywhere. The state has yet to redetermine eligibility for a single Medicaid expansion enrollee. By now, the state should have re-checked eligibility for more than 170,000 enrollees. Another 70,000 should be due for verification later this year or early next year.

To make matters worse, the Department of Human Services expects that up to 40,000 enrollees are still receiving benefits even though they’re no longer eligible. If those estimates are correct, taxpayers could be on the hook for up to $20 million per month to provide Medicaid expansion benefits to people no longer eligible.

Worst of all, state officials have facilitated this fraud by asking for waivers and continuing to kick the can further down the road. Meanwhile, nearly 3,000 children and adults with developmental disabilities are sitting on Medicaid waiting lists. Some of them have been waiting eight years or more for their needed home- and community-based services. They continue to wait, while Arkansas bureaucrats provide Obamacare welfare to 40,000 able-bodied adults who aren’t even eligible.

Welcome to Obamacare.

This article originally appeared at Forbes on May 11, 2015.

Forbes: Is AR Violating Federal Law By Not Verifying Eligibility For Its Obamacare Expansion?

By Nic Horton, Jonathan Ingram, and Josh Archambault

Arkansas’ Obamacare expansion has been a policy disaster and a political landmine, but supporters may have to add violating federal law to their list of problems. Internal e-mails from the Arkansas Department of Human Services reveal that the state has not bothered to verify that individuals enrolled in Obamacare’s Medicaid expansion are still eligible for benefits. This revelation comes with several legal and policy implications and should serve as a wakeup call to state legislators across the country.

Arkansas Hasn’t Verified Eligibility Of Obamacare Expansion Enrollees

Internal e-mails from the Arkansas Department of Human Services reveal that Arkansas has yet to begin verifying whether individuals enrolled in Obamacare’s Medicaid expansion are still eligible for benefits.

Forbes King

Federal law requires states to verify Medicaid enrollees’ eligibility at least once per year, and more frequently if the state receives information indicating they may no longer be eligible. But John Selig, director of the Arkansas Department of Human Services, recently admitted that not a single redetermination had ever been done for those enrolled in the Medicaid expansion.

Selig explained that he hopes to begin eligibility verification later this month, but the state began enrolling individuals in the expansion in October 2013 – more than 18 months ago. Really, the state should have already begun checking eligibility. Continue reading

Two Memos On Bad Health Care Proposals

downloadFGA Action recently published two memos on bad health care proposals in two states — Arkansas and Montana.

The Arkansas memo focuses on SB828, a bill that would delegate broad policy-making authority to state bureaucrats and allow them to pursue 1332 waivers:

Senate Bill 828 gives the executive branch virtually unlimited authority with no meaningful legislative oversight. Most disturbing is the fact that some of the bill’s defenders have falsely said that the bill actually requires legislative approval. Sadly, the bill’s express language confirms this is not the case.

Senate Bill 828 provides that “any waiver submitted [by the governor] under this section shall have legislative approval” to implement those waivers.6 The bill does not say that waivers shall require legislative approval, but that they shall be deemed to have already received legislative approval.

You can read the full SB828 memo here.

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Forbes: AR’s Private Option Architect Hopes To Revive The State’s Failed Obamacare Medicaid Experiment

By Nic HortonJonathan Ingram and Josh Archambault.  Mr. Horton is a policy impact specialist, Mr. Ingram is research director, and Mr. Archambault a senior fellow at the Foundation for Government Accountability.

Earlier this session, Arkansas lawmakers took an important first step in rolling back its disastrous Obamacare expansion. The legislature passed Act 46, which requires the Arkansas Department of Human Services to eliminate the Obamacare expansion by December 31, 2016. But a new bill proposed by one of the chief legislative architects of the failed Private Option experiment would reverse that progress and cement Obamacare into state law forever.

Days until the Private option is scheduled to end. 

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Forbes: Arkansas Voters Overwhelmingly Reject Obamacare’s Medicaid Expansion — Now What?

By Nic Horton, Jonathan Ingram and Josh Archambault — Mr. Horton is Policy Impact Specialist, Mr. Ingram is Research Director, and Mr. Archambault is a Senior Fellow at the Foundation for Government Accountability.

 

Arkansas has received its share of national attention the past few months, culminating in the spectacular defeat of incumbent Democratic U.S. Senator Mark Pryor by GOP Congressman Tom Cotton. In an electoral thumping powered by opposition to Obamacare, last night also saw the defeat of every Democratic candidate for Congress and all statewide offices.

But there’s one more Obamacare loss likely on the horizon in the Natural State: Arkansas’s disastrous “Private Option” Obamacare expansion. In fact, news is so bad that incoming state Senate President and Private Option cheerleader Jonathan Dismang may have to curtail his time campaigning for Obamacare expansion in other states.

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Governor-elect Asa Hutchinson has expressed concerns about the cost of Arkansas’ ObamaCare expansion, and he’ll be working with a legislature that’s looking for a way out of the program. (Photo by Win McNamee/Getty Images)

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