Ann Marie Marciarille: Missouri State of Mind: The Private Option for Medicaid Expansion:
I appreciate that the Missouri version of Arkansas-style Medicaid Expansion is being circulated without name as "Rough Draft No. One." The shoe fits. As far as I can tell, the proposal mimics in essentials Arakansas' 1115 waiver application… http://humanservices.arkansas.gov/dms/Documents/Final%201115%20Waiver%20Materials%20for%20Submission.pdf…. The "rationale" section of the Arkansas 1115 waiver application is the most interesting:
Arkansas Medicaid provides rates of reimbursement lower than Medicare or commercial payers, causing some providers to forego participation in the program and others to "cross subsidize" their Medicaid patients by charging more to private insurers….
States establish their own Medicaid provider payment rates within federal requirements and Arkansas has not chosen to be at the top of the permissible range…. What is the message: we need the commercial insurance market to save Medicaid from ourselves?