In May 2021, individuals who would be eligible for expansion coverage filed a lawsuit against the state. Previously, Governor Mike Parson announced that the state would not implement expansion because the ballot measure did not include a revenue source. Medicaid coverage under expansion began when the state started accepting applications in August 2021 and began processing applications in October 2021, with coverage retroactive to Jconsistent with a state supreme court order. Missouri voters originally approved a ballot measure in August 2020 that added Medicaid expansion to the state’s constitution and prohibited any additional burdens or restrictions on eligibility for the expansion population. In February 2022 the Missouri House passed a bill proposing a legislatively referred constitutional amendment that would impose work requirements on expansion enrollees and would also subject Medicaid expansion to legislative appropriations each fiscal year however, the 2022 legislative session adjourned without the bill’s passage in the Senate. CMS approved the state’s plan retroactive to Jon April 3, 2019. After former Governor LePage delayed implementation of the expansion for months, new Governor Mills signed an executive order on her first day in office (January 3, 2019) directing the Maine Department of Health and Human Services to begin expansion implementation and provide coverage to those eligible retroactive to July 2018. Maine adopted the Medicaid expansion through a ballot initiative in November 2017. Maine implemented expansion on January 10, 2019. Kentucky’s expansion program was originally implemented and continues to operate under state plan amendment (SPA) authority. The waiver had included a number of provisions including a work requirement, monthly premiums up to 4% of income, and coverage lockouts for failure to timely renew eligibility or timely report a change in circumstances. On December 16, 2019, newly elected Democratic Governor Andy Beshear signed an executive order rescinding the Kentucky HEALTH waiver that had been set aside by the court in March 2019. The state submitted four waivers at direction from this legislation however, only one has been approved to date. Following a successful expansion ballot measure in November 2018, in 2019 Governor Brad Little signed a bill passed by the legislature that directed the Idaho Department of Health and Welfare to seek waivers for multiple changes to the expansion program and specified that if the waivers were not approved by January 1, 2020, then all individuals up to 138% FPL will be enrolled in Medicaid. Under ARHOME, Arkansas is requesting to allow the state’s Qualified Health Plans (QHPs) to incentivize enrollee participation in health and economic independence initiatives and to consider QHP enrollees who do not participate in these incentives as “inactive” and reassign them to the state’s fee-for-service program this aspect of the request is still pending CMS approval.Įnrollment in Medicaid coverage under expansion began on November 1, 2019, and coverage for these enrollees began on January 1, 2020. Unlike Arkansas Works, ARHOME does not include work requirements. CMS also notified Arkansas that it would phase out the state’s premium requirement for the expansion population by the end of 2022. In December 2021, CMS approved Arkansas’ Section 1115 waiver request which would replace the state’s current Medicaid expansion program, Arkansas Works, with the Arkansas Health and Opportunity for Me (ARHOME) program. STATES THAT HAVE ADOPTED AND IMPLEMENTED EXPANSION In some states, these included previously-approved Section 1115 work requirements that have since been withdrawn by CMS under the Biden Administration. Coverage under the Medicaid expansion became effective Januin all states that have adopted the Medicaid expansion except for the following: Michigan (), New Hampshire (), Pennsylvania (), Indiana (), Alaska (), Montana (), Louisiana (), Virginia (), Maine ( with coverage retroactive to ), Idaho (), Utah (), Nebraska (), Oklahoma (), Missouri (Processing applications beginning with coverage retroactive to ), and South Dakota (Planned for ).Īrizona, Arkansas, Indiana, Iowa, Michigan, Montana, and Utah have approved Section 1115 waivers to operate their Medicaid expansion programs in ways not otherwise allowed under federal law.
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