Grant #75028

Grantee: University of Arkansas for Medical Sciences, Arkansas Center for Health Improvement

PI: Craig Wilson, J.D., M.P.A.

Grant Period: 2/15/2018 – 2/14/2019

Budget: $149,632

This project is funded as part of the Robert Wood Johnson Foundation’s solicitation, “Research in Transforming Health and Health Care Systems,” which seeks to build the evidence base on the potential effects of policies or policy changes intended to transform health. The goal of this project is to inform federal and state policy discussions about the potential effects of scaling back the financial eligibility threshold for Medicaid expansion populations. In 2013, Arkansas received a Section 1115 waiver to expand Medicaid coverage for the period 2014-2016 under a premium assistance model known as the “Private Option.” Nearly 300,000 individuals received coverage through the use of federal funds to purchase plans through the health insurance marketplace. In 2015, the state was approved for a five-year extension of its waiver, entitled Arkansas Works. In 2017, the Arkansas General Assembly passed additional modifications, including work requirements to maintain eligibility and a cap on eligibility at 100 percent of the federal poverty level (FPL). The state is seeking waiver modifications from HHS to implement these legislative directives and plans to eliminate coverage for individuals with incomes between 101-138 percent of the FPL. The researchers will examine the impact of the 100 percent FPL cap on Medicaid eligibility and address the following: (1) what proportion of individuals previously covered through Medicaid premium assistance with incomes between 101-138 percent FPL regain coverage and if so where; (2) how does removal of individuals between 101-138 percent FPL affect the profile of the Medicaid premium assistance program; and (3) does removal of Medicaid premium assistance for individuals between 101-138 percent FPL affect the actuarial risk pool and thus premiums on the marketplace? Deliverables will include a project work plan and final narrative and financial reports. The grantee will also produce paper(s) suitable for publication and present findings at national research meetings and to other stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels, as part of the deliverables for this grant.