Gov. Hutchinson says state’s disability waiting list down by 500, thanks Tobacco Settlement Commission

Gov. Asa Hutchinson on Tuesday (Dec. 12) publicly thanked the state Tobacco Settlement Commission (ATSC) for its support in paring down more than 500 families on the waiting list for a Medicaid waiver program that provides services offering home and community-based care for developmentally disabled children.

During the legislative session earlier this year, lawmakers approved House Bill 1033 that allowed the state to take $8.5 million from the ATSC’s annual allotment of tobacco settlement funds to use as matching funds to receive additional federal dollars of over $21 million. At the time, it was estimated that between 500 and 900 people on the waiting list will be able to get Medicaid-funded services under this proposal.

The money has allowed DHS to reduce the waiting list of more than 3,000 developmentally disabled Arkansans seeking in-home care by more than 500.

“If you remember, I think it was a year ago or thereabout, I came in here to this Commission meeting and I asked you to support devoting part of the Tobacco Settlement proceeds to reducing the waiting list. And I wanted to thank you for it,” Hutchinson told the Commission’s nine-person board at ATSC’s downtown Little Rock offices.

“That is a great success story,” Hutchinson said with one of the families that has received services at his side. “I am very proud of the Commission for your support of this. This is an ongoing effort, and you just can’t stop at the 500 families.”

Through an initiated act campaign in 2000, Arkansas voters passed the Tobacco Settlement Proceeds Act that funded the ATSC and other programs, including tobacco control and cessation activities, expanded Medicaid services, and development of the Minority Health Commission.

Earlier in July, Hutchinson announced during a speech at a Little Rock Rotary Club meeting that the state had made strides in reducing the waiting list as part of the administration’s goal to cut in half the number of people with intellectual and developmental disabilities stuck on the waiting list for home and community services.

In the past, Hutchinson said he hopes the other 80% of the state’s developmentally disabled population that has been on the waiting list for more than a decade will soon be provided those same services. According to Department of Human Service (DHS) officials, the state provides services for 30,000 individuals with behavioral health needs and/or intellectual or developmental disabilities. Altogether, DHS spends more than $1 billion annually on this population, not counting costs for human development centers, nursing homes and assisted living facilities.

Before HB 1033 was approved by the legislature and passed into law 10 months ago, developmentally disabled individuals on the state’s waiting list received health coverage under Arkansas Works, the program that purchases private health insurance for more than 300,000 lower-income Arkansans. HB 1003, which is now Act 50 of 2017, redirected $8.5 million in Tobacco Settlement proceeds into state funds that provided insurance coverage through the now obsolete AR Health Networks program.

This is not the first time the Hutchinson administration has tapped the Tobacco Settlement funds to shore up other state programs or budget costs. After closing out the regular session in early May, the Arkansas General Assembly approved a Hutchinson-backed proposal during a special session to transfer $105 million from the voter-approved Arkansas Healthy Century Trust Fund to the newly created Long Term Reserve Fund.

According to state budget officials, monies from the tobacco settlement provided core funding for the trust fund, which has been gaining in interest for nearly 17 years. At the end of fiscal year 2017, which ended on June 30, there was nearly $103 million in the account, with lawmakers’ having accessed more than $30 million in interest to fund programs related to health initiatives.

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Hutchinson also said he was pleased with the U.S. Senate’s decision to adopt a proposal sponsored by Sen. Tom Cotton, R-Little Rock, to repeal the Affordable Care Act’s individual mandate that was inserted at the last-minute into a comprehensive bill to overhaul the nation’s tax code.

“First of all, I support doing away with the individual mandate. I think that is a fundamental part of freedom, but that sets the stage for more flexibility for the states in reforming and managing the Medicaid program and health care as a whole,” Hutchinson said.

But Hutchinson also warned there are still challenges to fixing the nation’s healthcare system, noting that he is still awaiting approval for a long-sought after federal waivers from the Trump administration to cap income eligibility for the state’s Arkansas Works program at 100% of the federal poverty line.

“It’s important that we just not dismantle and do away with the individual mandate, but we have a strong plan to replace it with. If we are to make sure we have a health care system that (addresses) states’ need, then we are going to have to have more flexibility.” he said.

According to state officials, the first waiver would reduce the number of Arkansans Works recipients with incomes up to 138% of the federal poverty line by about 60,000. Individuals with higher incomes would move to the federal marketplace and be eligible for federal subsidies. They would pay up to 2% of their income for their insurance, which they could lose if they don’t pay.

The second requested waiver would add a requirement for able-bodied recipients to work, be engaged in work training, or volunteer with a charitable organization. Under Arkansas Works’ existing waiver granted by the Obama administration, recipients are referred to the Department of Workforce Services. However, few beneficiaries are taking advantage of that benefit.

The third waiver would replace Arkansas Works’ employee-sponsored insurance component with a program targeting individuals working for small businesses and earning 75%-100% of the federal poverty line. The state would provide funding for insurance premiums up to the amount it would have paid for an individual in Arkansas Works. Employees would receive the same benefits as coworkers but without additional “wraparound” benefits.

The final amendment would make Arkansas an “assessment state” rather than a “determination state,” meaning Arkansas rather than the federal government would determine eligibility.