When Arkansas legislators and then-Governor Mike Beebe expanded Medicaid to able-bodied adults through ObamaCare, supporters claimed their plan was something other states were closely watching and, before it was even implemented, was serving as a national model. What unfolded, however, was a fiscal and moral disaster that no other state dares to fully replicate.
Recent reports indicate that Arkansas’ ObamaCare experiment is nearly twice as expensive per-person as a conventional Medicaid expansion would have been. If that weren’t bad enough, more able-bodied adults signed up for this welfare expansion than state officials promised would ever even be eligible.
Now as state taxpayers begin feeling the brunt of budget shortfalls and skyrocketing enrollment, one Arkansas lawmaker is working to stop the bleeding.
{mosads}Rep. Josh Miller (R-Ark.) has filed legislation that, if enacted, would seek a waiver from the Trump administration to stop new ObamaCare expansion enrollment. As long as current enrollees maintain their eligibility, they would be allowed to stay on the program. However, the front door to the program would close and no new enrollees would be able to sign up.
This approach is far from untested. Arizona and Maine have both used enrollment freezes to wind down earlier Medicaid expansions to able-bodied adults after the programs faced massive cost overruns. Both were approved by the Obama administration. In both states, enrollment gradually declined as existing enrollees lifted themselves out of poverty, freeing up scarce resources for the truly needy.
Based on the experiences of these states, stopping new enrollment in Arkansas could reduce enrollment in the expansion by more than 60 percent during the next two years.
Aside from the fiscal benefits of moving adults out of dependency, an enrollment freeze is an immediate step towards prioritizing the truly needy Arkansans who have been pushed to the back of the line since the state expanded Medicaid to able-bodied adults.
One of those Arkansans is a little girl named Skylar Overman. Skylar has a rare neurological condition that requires around-the-clock care. But Skylar has spent nearly her entire life on a Medicaid waiting list for needed services. In fact, she moved down the list nearly 100 spots in 2016.
Unfortunately, Skylar is not alone. There are nearly 3,000 Arkansans who, like her, are stuck languishing on the waiting list. Since the state expanded Medicaid under ObamaCare, the waiting list has grown by nearly 700 people, while 79 individuals with developmental disabilities have died before ever getting the care they needed. Freezing enrollment in ObamaCare expansion would immediately begin to free up space for these truly needy individuals within Arkansas’ budget.
Arkansas would be the first state to make a formal push to stop expansion enrollment under the Trump administration. But if Arkansas’ waiver makes it across the finish line, other states will likely (quickly) follow suit, finally making Arkansas a real model for the nation.
And regardless of where the bill ultimately ends up, there could be big ripple effects at the federal level. As Congress continues working through the weeds of ObamaCare repeal, an enrollment freeze for expansion states is an effective and palatable option that’s on the table and one that is already generating attention on the hill.
It’s clear that expansion states need options to rein in enrollment. Based on a survey of every expansion state with available data, every single state has enrolled more able-bodied adults than they expected to ever sign up. In fact, these states have enrolled more than twice as many adults as anticipated. This enrollment explosion has resulted in billions of dollars in cost overruns in states from Kentucky to Illinois to Oregon, redirecting limited taxpayer resources away from the truly needy and other budget priorities.
This proposed legislation is a clear signal to Congress that an appetite for enrollment controls exists in the states. Arkansas should pass it post haste and the Trump administration should approve the waiver request as soon as possible to protect the truly needy.
Nic Horton is a senior research fellow for the Foundation for Government Accountability.
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