Gov. Asa Hutchinson emphasized the positive to the legislature today in recounting his latest communication from Health and Human Services Secretary Sylvia Burwell about his proposals to change the Obamacare-enabled Medicaid expansion. Hutchinson wants it to continue, but with some amendments.

Hutchinson said he was encouraged Burwell indicated a willingness to work with the state on ideas to encourage small businesses to participate in a premium assistance program. But she also reiterated opposition to other ideas.

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Specifically, she said an asset test for newly eligible people is prohibited by law. Nor will she approve a work requirement. Instead, Hutchinson wants to require referral to job training, which has goals Burwell said she supported.

But she also expressed opposition to Hutchinson’s desire to end 90-day retroactive coverage for new adults in the program. “Retroactive coverage is an important Medicaid provision that protects people who need medical care, and who may not know that they are eligible for coverage. Retroactive coverage is especially important when issues with a state’s eligibility and rollment systems lead to unnecessary gaps in coverage. [Arkansas had a disastrous experience with this.] We recognize recent improvements Arkansas has made to its eligibility and enrollment system, but significant additional progress is needed to ensure that all eligible individuals are enrolled in Medicaid in a timely manner and in accordance with Medicaid rules and remain enrolled as long as they are eligible.”

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NOTE FROM DAVID RAMSEY: There’s some potential wiggle room in Burwell’s note on 90-day retroactive coverage. Unlike work requirements and asset tests, she didn’t give a hard no. The feds have allowed other states to eliminate retroactive coverage if they have a good policy reason and can prove that they have safeguards in place to protect beneficiaries from coverage gaps. In other words, Burwell could still give the okay to Hutchinson’s request on retroactive coverage, but the feds will need more assurances from the state than they’ve gotten thus far.  

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