Republican legislative leaders in the House and Senate asked the Beebe administration to slow the process for a potential Medicaid expansion and to consider a laundry list of reforms.

In a letter dated Wednesday, July 25, Arkansas Department of Human Services director John Selig was asked to slow down on decisions to adopt expanded services for Medicaid under the auspices of the federal health care law. Gov. Beebe (D) and Arkansas Medicaid Director Andy Allison were copied on the correspondence.

The U.S. Supreme Court ruled in June the individual mandate portion of the federal law was constitutional, but it gave states flexibility to opt in or opt out of an expanded Medicaid program without penalty.

Gov. Beebe has said he is “inclined” to move forward with a Medicaid expansion, which would be paid for during the first 3 years by the feds. By 2021, states would have to pick up 10% of the Medicaid expansion tab.

Beebe said he is asking the federal government for more details on the possible expansion, such as whether states can opt out without penalty at a later date.

The GOP letter quotes a U.S. Department of Health and Human Services response to Virginia's Governor that says “there is no deadline” for a state to tell

the federal government when it plans to expand Medicaid.

“Since there is no deadline for making a decision on Medicaid, we believe it is prudent to proceed in a deliberative manner to make sure that all decisions made on the issue are in the best interest of hardworking Arkansas taxpayers and the future of Arkansas,” the letter states. “As is evident from issues that resulted from decelerated implementation of the new payment improvement initiative, we propose to slow the process, involve more stakeholders, and take a more methodical approach to Medicaid reform.”

The letter is signed by Republican Reps. Terry Rice, Bruce Westerman, Mark Biviano and Sens. Johnny Key and Michael Lamoureux.

The letter asks for the following Medicaid reform items to be considered:

  • Global Consumer Choice Waiver – which provides more flexibility to patients, the state and providers
  • Random drug-testing for working age adults – to screen for substance abuse
  • Enhanced eligibility verification for Medicaid recipients – a testing system for income and other eligibility thresholds
  • Increased co-pays for some services – to provide revenue for state program and help consumers understand cost of health care
  • Controls to reduce waste, fraud and abuse – using technology such as smart ID cards to prevent non-enrollees from using services and to better track system data.
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