Explainers

Arkansas Medicaid Eligibility Redetermination Process

August 1, 2015

Contact

Joseph W. Thompson, MD, MPH
President & CEO
501-526-2244
achi@achi.net

 

Arkansas’s executive and legislative policymakers have faced recent scrutiny about the eligibility redetermination process for approximately 600,000 Arkansans with healthcare coverage through Medicaid. The redetermination process—that requires new information system functionality to accommodate a new method of assessing family income—has been delayed by the Arkansas Department of Human Services pursuant to a waiver granted by the federal government to deviate from the standard timelines for redetermination. Approximately two-thirds of states have been granted such waivers to address challenges related to information system development and connectivity to enable redeterminations. Roughly 220,000 individuals in private plans provided by the Health Care Independence Program (HCIP) have been a part of the state’s bulk eligibility redetermination process this summer.a The process has been marked by confusion among enrollees, advocates, and policymakers.

This fact sheet describes the state’s process for eligibility redetermination and seeks to provide clarity about important concepts that guide the process.