If you’re reading or watching the news lately, I’m sure you see daily news stories and discussions about Medicaid -both the Medicaid that serves low-income children, those with disabilities, and the elderly AND the opportunity to extend Medicaid coverage to 250,000 uninsured Arkansans.  Since Medicaid is such a hot topic, it’s always nice to revisit how Medicaid is there for our state’s children.

We know that more than 2/3 of today’s Medicaid recipients are children – when you do the numbers, about half a million children who depend on Medicaid or ARKids First for their health care needs.  At AACF, we have long advocated for simplifying the eligibility and enrollment process for children, allowing families to focus on working and going to school rather than dealing constantly with enrollment forms, income documentation, or meetings with caseworkers.  Thankfully, the Affordable Care Act protects simplified eligibility and enrollment processes for children through 2019, through a provision called Maintenance of Effort (MOE).  For adults, the MOE remains in effect until January 2014.

The ACA’s Maintenance of Effort requires Arkansas to maintain, at minimum, eligibility standards for Medicaid and ARKids First that were in place in March 2010.  While allowing simplifications and streamlining of eligibility, the MOE prevents states from adding new paperwork requirements or other barriers such as in-person meetings that could be a barrier to care for children. The MOE is in effect for children until September 30, 2019, meaning no new restrictions can be added before then. Violation means states lose all of their federal Medicaid funding.

Some bills that have been filed already this legislative session likely violate the MOE for children, including HB1256 and SB248.  These bills propose using “biometric smart cards” to prevent fraud in Medicaid, but they require face-to-face encounters to fingerprint and photograph an individual for the smart card. This additional requirement for enrollment would make eligibility standards, methods, and procedures more restrictive since children do not have to have a face-to-face interview to enroll in ARKids First today. Fingerprint scanners would be placed at all points of service, including doctor’s offices, hospitals, pharmacies, and therapy locations, requiring Medicaid and ARKids First recipients to scan in and out of providers’ offices to receive services.

We obviously have concerns about the impact this type of program could have on children, and we are thankful that the Affordable Care Act protects children during tough financial times.  Though there are some types of optional services that could be cut from ARKids First, we know that children who are eligible for ARKids First today should remain eligible. If Arkansas chooses to extend Medicaid, even more already-eligible children will access coverage when their parents enroll.   Strengthening Medicaid is a good deal for our state and opens up eligibility to hard-working adults, including 80,000 parents.