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Infographic showing result of decision by states to refuse Medicaid expansion money.

Arkansas' version of Medicaid expansion under the Affordable Care Act, its "private option," has been a rousing success, having signed up 75 percent of the state's eligible population so far, and still going strong.
The state's Department of Human Services said more than 170,000 people have applied and were determined eligible for Arkansas's "private option" program, which is about 14,500 more than how many people had signed up last month. Department officials say around 225,000 Arkansans qualify for the program, which uses federal Medicaid dollars to purchase private health insurance for the poor.

After a legislative hearing, the director of Arkansas's Medicaid program Andy Allison said the May numbers were meeting expectations quicker than different health care programs established before it.

"What I would say is that we're reaching the predicted levels of participation far quicker than previous expansions," he said. "Not sure we should be surprised by that given the scale and attention placed nationally on coverage, which is unprecedented."

People can sign up for Medicaid any time, and don't have to wait for an open enrollment period as they would if buying a fully private plan. So it's not impossible for Arkansas to reach nearly full enrollment in the program this year. The program has been so successful so far that the debate on it in the legislature is shifting from the very existence of the program to whether there's adequate coverage for everything across the state. In this hearing, "some legislators were concerned that access to vision and dental care offered by one health insurance provider under the state's 'private option' program wasn't equal across Arkansas." It's pretty significant that the conversation in Arkansas has moved from making sure people have basic, essential health care to whether everyone has equal access to eye doctors and dentists. That's real progress.

As is the fact that Arkansas' uninsured rate has dropped, that early data shows that fewer uninsured people are showing up at acute care hospitals, that the population of people in the private option are much younger than the population in the fully private exchange, and that premiums will probably be lower going forward. There's still a lot to be proved for privatized Medicaid, but in Arkansas, it's meant more than 170,000 people who wouldn't have otherwise had care now do.

Originally posted to Joan McCarter on Wed May 28, 2014 at 12:03 PM PDT.

Also republished by Obamacare Saves Lives and Daily Kos.

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Comment Preferences

  •  Tip Jar (42+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Wed May 28, 2014 at 12:03:52 PM PDT

  •  Great (0+ / 0-)

    Now the precedent has been set to privatize the whole program down the road.  But I'm sure that some way, somehow, this will bring us closer to single payer.  As promised.

    "When dealing with terrorism, civil and human rights are not applicable." Egyptian military spokesman.

    by Paleo on Wed May 28, 2014 at 12:10:57 PM PDT

    •  There is no way to divine what combination of (12+ / 0-)

      political and economic forces might get us to single payer, but the more people who have coverage under the ACA, the more likely we are to keep moving in the direction of universal coverage.  We need first to get to the tipping point where access to health care is accepted as a right, not a privilege.

      “The future depends entirely on what each of us does every day.” Gloria Steinem

      by ahumbleopinion on Wed May 28, 2014 at 12:26:52 PM PDT

      [ Parent ]

    •  I'm sure that the 170K people who can (5+ / 0-)

      now get some sort of health coverage DON'T agree with your sarcasm.  But, since they don't mean anything to you, you don't need to bother.

      •  But is it usuable? The last thing I heard was (1+ / 0-)
        Recommended by:

        that the private option was going to have some pretty nasty deductibles and copays thus making it pretty much impossible to use.  After all, if your total monthly income is around say, $1000 a month good luck coming up with a $3000-$4000 deductible!

        You have watched Faux News, now lose 2d10 SAN.

        by Throw The Bums Out on Wed May 28, 2014 at 01:32:25 PM PDT

        [ Parent ]

        •  ALL FALSE. OK? Now I'm going to have free (2+ / 0-)
          Recommended by:
          bluenick, jazzman143

          MediCaid, due to all the good rules changes. The ACA isn't just about putting people into the private ins. pool, much more to it than that, such as not only expanded MediCaid with a higher minimum income, but all sorts of regulations on private insurance so that benefits are universally accessable and in many cases free, such as office visits and preventive care. I've never seen any state where the Bronze to Platinum level private ACA plans have that high deductibles.It's usually ranging from yes ZERO to $300 for a modest income, and a high of $500 for the top platinum plan for the highest ACA subsidized plan. Stop the Freaking Lies.

          Anybody whose plan is above subsidized income was paying before usually much more, and also there was the idiotic pre existing conditions. Do the anti ACA freaks want to bring that s---t back?

          Stop the idiocy, Stop the classist bs., stop the lies.

      •  How the hell do you know? (3+ / 0-)
        Recommended by:
        MichiganGirl, jazzman143, Jeffromac23

        How do you know they don't mean anything to Paleo?   I'm strongly opposed to Medicaid privatization - because it means that some of money which could be going to patient care, will instead be diverted to jack up insurance company profits.

        Enough already. We need to kick the corporations out, not privatize every damned thing on the planet, which is where it's headed.

        I am become Man, the destroyer of worlds

        by tle on Thu May 29, 2014 at 06:45:28 PM PDT

        [ Parent ]

    •  I think the ACA will be the trial run (1+ / 0-)
      Recommended by:

      for privatization of medicare.

      If the exchanges are good enough for those below 65, it will be hard to make the argument that they aren't good enough for the medicare eligible.

    •  Privitized medicare (4+ / 0-)
      Recommended by:
      Paleo, charliehall2, indres, Team Leftie

      otherwise known as medicare advantage is where Obamacare got a portion of its money to pay for the subsidies adn expanded medicaid.
      As will probably be the case privitized medicaid will cost more while providing lower quality of services adding more evidence to the fact that government run health programs are better.

      Side note privitized medicare cost 20% more despite having health outcomes at least 7% worse

      We only think nothing goes without saying.

      by Hamtree on Wed May 28, 2014 at 07:39:16 PM PDT

      [ Parent ]

    •  Who promised single payer? (0+ / 0-)

      Not Barack Obama!

  •  Can somebody explain what it is? (4+ / 0-)

    Their private option.

    I mean is this just some way to make the ACA palatable to rednecks or is it some sort of giveaway to big business that is inferior to the medicaid expansion?

    •  it's the insertion of a private (3+ / 0-)
      Recommended by:
      Lujane, raincrow, kfunk937

      insurance middleman to skim off some profits from the delivery of health services.

      That makes medicaid palatable to many.

      In traditional medicaid, there is no iprivate, for profit, nsurance middleman.

      •  except that in states like OH (1+ / 0-)
        Recommended by:

        use of MCOs for Medicaid does essentially the same thing, with Medicaid MCOs alongside the traditional (don't ask me how they shoehorn folks into one, rather than the other). And  managed care is attractive/salable to "control costs." MCOs function more like HMOs or PPOs, so even with more service bottlenecks & exclusions, it seems to be easier overall to find providers that accept it. Maybe their capitation/reimbursement rates are better, I dunno.

        I think you've got something there, blue, with insertion of private middlemen to skim off some profits . . . making it palatable to many. I may quote you on a Tshirt.

  •  Keep in mind about medicaid (4+ / 0-)
    Recommended by:
    Lujane, raincrow, kfunk937, charliehall2

    For at least the past 20 yrs., federal rules governing medicaid require a clawback of benefits from a deceased beneficiary's estate.

    1.  For benefits received prior to age 55, the only clawback is for a beneficiary who is institutionalized permanently.

    2.  For beneficiaries between 55 and 65, the clawback encompasses all benefits received.  For states such as Arkansas which have privatized medicaid, this clawback encompasses all amounts paid by the state for premiums, even if the beneficiary never made a claim.

    Lest there be some confusion, this post age 55 clawback is not limited to nursing home care, but all costs paid.  Medicaid paid for a $45,000 operation?  The clawback kicks in.

    Many poor people in rural areas may well own a home which will be claimed by the state medicaid authorities on death.

    So, when the poster claims that the federal government picks up the tab, that's only a partial truth.  The beneficiary is also liable.

    If the medicaid qualified individual earned a few dollars more, that person would then be entitled to purchase subsidized private insurance, with no clawback for the subsidy.

    •  Thank you for this sobering reminder. (0+ / 0-)

      Our health care delivery system is still SICK SICK SICK.

      Fight them to the end, until the children of the poor eat better than the dogs of the rich.

      by raincrow on Wed May 28, 2014 at 05:31:40 PM PDT

      [ Parent ]

    •  Any examples of this happening, or is this just (2+ / 0-)
      Recommended by:
      indres, Rob in CT

      a RW myth? I know they peddle this notion at the RW sites. Any links to prove it?

    •  Here is a solution. (1+ / 0-)
      Recommended by:
      scott jones

      Extend the maximum ACA subsidies to those living below the poverty level.  This solution would work even in states without a "private option" and have not extended Medicaid.  

      As it now stands, there are no subsidies for those in poverty.  Though poor, many people would find a way to come up with the modest premiums.  

      Some may have inherited a home they also wish to pass down to their sons, daughters, nieces, or nephews, and do not want the state taking it when they die.  Don't force people to be on welfare.  

  •  Every state's Medicaid is different (5+ / 0-)

    In TN I have Blue Care. I've had three office visits just lately and a chest ex- ray, CT scan x  two, blood work twice.
    Being a low income senior I have Medicare too. Medicare pays first and if Medicaid (Blue Care)ever pays I'm unaware of that. Medicaid pays all but a small amount of my prescription drugs. I pay for over the counter meds.

    Thinking about the shape our health care is in and the reality of expenses incurred by people who in no way can afford to pay is sad. I've read accounts of and watched videos of Canadians telling about going to the doctor and never discussing cost. That's me with the coverage I have here in Tennessee but I know others don't have this.

    If everyone could have the coverage I have we'd have single payer or what's called Improved Medicare for All. A Universal Health System.

  •  Given that Medicaid in most states is junk (1+ / 0-)
    Recommended by:
    scott jones

    insurance, failing to reimburse providers adequately, a private option might well be worth trying.

    •  My friend has medicare and medicaid, what medicare (0+ / 0-)

      does not pay, his medicaid pays. He is a low income senior citizen. He has zero out of pocket costs due to his income.

      He is very pleased with it as it covers all of his medications, hospitalizations, treatments, surgeries , the works. The only thing he cannot get covered is dental care. He has no dental insurance and only one doctor who is an hour away from his residence takes medicaid for dental care. There is no way for him to get there as we do not have buses and trains in Central PA that travel that far except buses that are for longer trips to say Philly or Pittsburgh or a city region or out of state.

      His doctor will not allow him to drive so lending him my car would not work so I may have to find a way to get him to the dentist even though I live over an hour from him and 2 hours away from that dentist.

      Keystone Liberals on Twitter @ KeystoneLibs , Join PA Liberals at

      by wishingwell on Thu May 29, 2014 at 06:31:06 PM PDT

      [ Parent ]

    •  private option (0+ / 0-)

      Skimming a level of profit from junk insurance will just make it worse.

      •  True, but.... (0+ / 0-)

        The Rethugs are willing to spend money to help their allies in the 1% when they aren't willing to spend money to help the poor. And insurance profit margins are actually pretty slim. So the private option might have the unintended consequence of providing better care for the poor.

  •  cost of healthcare (3+ / 0-)
    Recommended by:
    scott jones, Team Leftie, DQKennard

    The "private option" costs 50% more than the regular expanded Medicaid.  Private means for profit......and how many fiscal conservatives will rise up against this huge waste of precious healthcare resources?  


  •  Coverage (1+ / 0-)
    Recommended by:
    scott jones

    I can only imagine the thrill of those who heretofore had no coverage due to pre-existing conditions or lacking adequate income for appropriate care, are now feeling so much better and are going to their physicians and exercising preventative medical health care in a responsible manner. This must be wonderful news for 200,000 folks in Arkansas, as opposed to the racial bigot of a Governor in Florida who is denying coverage just because he hates the ACA and the POTUS. Nice work Arkansas, nice work, actually doing something for your citizens as opposed to lying on a bedpost and hating the POTUS or ACA. To those of you who hate the ACA or even the concept, get broke and then get real sick and see how you enjoy that status.

  •  "success"?? (1+ / 0-)
    Recommended by:
    Arkansas' version of Medicaid expansion under the Affordable Care Act, its "private option," has been a rousing success,
    If by "rousing success" you mean providing worse health care for more money than ordinary medicaid, then point taken.

    But IMO it's pretty disgraceful that the party line of a supposedly progressive blog is standing foursquare behind the idea that this needless, catastrophically damaging cave-in to Republican extortion represents any kind of "success".

  •  Here's why I believe Red states are opting out... (0+ / 0-)

    The more people who enroll, the harder it will be to for them to repeal it--EVER!! There's probably millions in those poor red states who would benefit from the ACA expansion. If you let all those people have it and then suddenly take it away, it becomes a HUGE incentive for people, especially poor people, who possibly don't vote to start voting.

    Verses if you never let them have it in the first place, most won't ever know what they missed out on, nor would they have a sense of loss.

    That's why I've always believed they have been so frantic about trying to repeal before implementation. Because the more people who enroll, the less likely they'll ever be able to repeal it without paying a huge price politically.

  •  Please Help (0+ / 0-)

    Please help us and tell Governor (of Alabama) Bentley to expand Medicaid.  Here’s his contact number 334-242-7100 or fax 334-353-0004.

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