HJAR Mar/Apr 2023

38 MAR / APR 2023 I  HEALTHCARE JOURNAL OF ARKANSAS POLICY COLUMN POLICY LATE LAST YEAR, Congress avoided a government shutdown by approving a $1.7 trillion omnibus spending package that, as usual, contained provisions addressing a wide array of policy priorities. This omni- bus package was unusual, however, in its heavy emphasis on healthcare. Among the more than 4,000 pages in the Consolidated Appropriations Act of 2023 are hundreds of pages of healthcare-related provisions, many of which will have significant impacts on Arkansas. Topics addressed in the legislation include: Medicaid redeterminations. During the COVID-19 public health emergency, states received enhanced federal Medicaid fund- ing under the condition that they would not terminate coverage for most enrollees. This put a pause on the process of redetermining enrollees’ eligibility, causing Medicaid rolls to swell, but the federal budget act allows states to resume the redetermination pro- cess in April. The federal government allows states up to one year to conduct the redetermination process, but the Arkansas General Assem- bly enacted a law in 2021 that requires the state to complete redeterminations within six months. 1 Even under a yearlong timeline, this would be a massive task for Arkansas, where about a third of the population is en- rolled in either traditional Medicaid, ARKids First, or theArkansas Health and Opportu- nity for Me program. The self-imposed, six- month timeline means Arkansas Medicaid officials will face one of the most challenging tasks in the program’s history. Continuous Medicaid enrollment for children. The budget act requires all state Medicaid programs to keep children en- rolled continuously for 12 months after they are deemed eligible. This should re- duce churn — moving in and out of cov- erage within a short period of time — and increase stability in the lives of vulnerable young Arkansans. Medicaid postpartum coverage. During the COVID-19 public health emergency, states have had the option of extending Medicaid coverage for new moms from the federally mandated 60 days postpartum to one year postpartum. The budget act makes this op- tion permanent. A majority of states have exercised this option during the public health emergency. 2 At this writing, at least one bill has been filed in theArkansas General Assembly to extend postpartum coverage to one year, a policy change that has been endorsed by the Health Congress’ Omnibus Spending Package: A Heavy Emphasis on Healthcare