Gov. Jay Nixon cites Arkansas Medicaid expansion as potential model in Missouri

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JEFFERSON CITY - Missouri's Democratic governor cited a Medicaid expansion plan pushed by a Republican legislature in Arkansas as a plausible model for Medicaid expansion in Missouri.

In Arkansas, Democratic Gov. Mike Beebe has pushed for Medicaid expansion but the Republican-controlled Arkansas legislature has come up with an alternative plan. The plan proposed by the Arkansas legislature would create the "exchange plan" that would provide private health care coverage as an alternative to expanding Medicaid.

In February, Beebe met with the U.S. Department of Health and Human Services Secretary Kathleen Sebelius, to discuss that alternative. Beebe received permission for Arkansas to implement an exchange model rather than expanding Medicaid. Under an exchange system, health care plans would be managed by private insurance companies rather than the state.

Amy Webb, the director of communications for the Department of Human Services in Arkansas, said the legislation that would create a private insurance option rather than expanding Medicaid was filed and passed out of a state Senate committee on Tuesday, April 2. The bill would increase private health care options and decrease government operated programs such as Medicaid. The Arkansas plan would provide coverage to individuals with incomes below the 139 percent federal poverty level, as is required by the federal law.

After the passage of the Affordable Care Act, Medicaid expansion has become an important issue in many state legislatures. Many states, including Missouri, are looking at alternatives to the Medicaid expansion plan set by the federal health care law. According to the Arkansas Department of Human Services website, the Arkansas bill would potentially improve access to quality health care and create competition within the insurance marketplace that would attract insurance companies.

Under the Arkansas plan the federal government would provide the funds for Medicaid expansion to the state, however the funds would be allocated towards enrolling recipients in private insurance plans.

Nixon met with the House Republican Caucus to discuss Medicaid reform Wednesday and expressed optimism about expanding Medicaid. He cited the plan moving through the Arkansas legislature. He said he believes a market-based system similar to the proposed model in Arkansas would reduce prices and create better care. Nixon also said he hopes personal responsibility from Medicaid recipients would be improved.

"Whether it's a model that looks similar to some of the things that are going on in Arkansas, the things that are going on there to have some private insurance bought, but a market based system that gets competition involved," Nixon said.

Nixon touted while not explicitly abandoning Medicaid Expansion he said there were other ways to accomplish the same objective.

"The model has to get to 138 and there are ways to get there that are not just, in essence, an expansion of the current system," Nixon said.