DHS director working on state baseline study, confident Arkansas Works will get approval

Arkansas Department of Human Services Director Cindy Gillespie is hoping a new baseline study effort can position state policymakers for better future decisions, and she’s still bullish on the state’s chances to gain federal approval of Arkansas Works.

Appearing on this week’s edition of Talk Business & Politics, Gillespie, who has served during the tenure of Gov. Asa Hutchinson, said that the resignation of U.S. Health and Human Services Secretary Tom Price over an air travel scandal is one major reason for the Arkansas Works delay.

“Our waiver, at the end of the day, has to be approved by the Secretary of HHS. The Secretary of HHS left. Tom Price,” said Gillespie. “So that’s a hold up. As they were going through considering Graham-Cassidy and considering various versions of healthcare reform, all of those slowed down work on waivers, so I think there’s just a lot going on back there.”

Arkansas Works is the governor’s updated version of the private option, which expands Medicaid under provisions of the Affordable Care Act, or Obamacare.

Gillespie said she is confident that the feds will eventually approve a waiver that Arkansas is seeking to shrink its Medicaid expansion population and to add work requirements to participants.

“The law allows us to do what we want to do,” she said.

The leader of the largest state agency in Arkansas also said that President Donald Trump’s call to end insurance premium subsidies would not impact Arkansas Works, a position that Gov. Hutchinson holds.

“Arkansas Works won’t be affected by that. So what’s happening is, if you think about the market, maybe a quarter of the market is losing the … not the premium subsidies, but they’re losing subsidies that are there for their cost-sharing – their deductibles and co-pays, right? So that money instead, for that quarter, is being blended into the premium payments,” Gillespie said.

“So the federal government for those folks will still be subsidizing the premiums, and they’ll subsidize those premiums now at a greater number. A simple explanation, on that side of the market, the way it works is if the individual’s paying $20 a month for a $500 premium, they’re gonna pay $20 a month for a $570 premium… The Feds are still gonna pick up all of the cost. It’s just now going to come through the premium tax.”

Last week, Gillespie’s agency as well as the Arkansas Insurance Department and the Arkansas Department of Workforce Services announced a new baseline study to gauge various aspects of health insurance coverage across the state. She says that survey will allow for future policy decisions to be made with data.

“There’s been four years now of change, of more people being insured, change in products, changes in Medicaid. We need to see what we look like today. Without that baseline, we can’t really look at options for how to make all of our insurance products more affordable, how to make Medicaid more sustainable. We need a baseline,” Gillespie said.

Watch her full interview below, including her hopes for the Alexander-Murray health reform proposal, Children’s Health Insurance Program funding, and Community Health Center funding.