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« Five Arguments Against A State Insurance Exchange | Main | How Medicaid Expansion and the "Private Option" Will Lock Its Clients Into Poverty »
Tuesday
Apr162013

Can Arkansas Escape From Medicaid Expansion if the Federal Government Breaks Its Commitments?

Despite a failed vote yesterday on HB 1219, Arkansas House members are likely to have another bite at the apple today on funding the “private option.” Lawmakers have spent a substantial amount of time this session creating and designing this particular version of Medicaid expansion, which would funnel Medicaid payments through private insurance companies. Legislators who must choose whether to fund Medicaid expansion (whether it is labeled the private option or not) should understand that a central argument made in expansion’s favor is groundlessly overconfident.

More precisely, the advocates of the private option version of Medicaid expansion have explained that, if their plan does not work as expected (if, for instance, the federal government fails to make good on its future commitments), then Arkansas can always exit the expansion and return to the previous status quo. Unfortunately, private-option advocates have ignored both statutes and case law when explaining that Arkansas can always check out of the private option if the federal government fails to meet its funding commitments. Advocates of the private option therefore make a fundamental mistake when they explain that Medicaid expansion can risklessly be explored or casually exited; in fact, there is substantial reason to believe that when a state chooses Medicaid expansion, it is something like a decision to go down a one-way street. 

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