Arkansas medical groups urge Trump administration to grant 2-year reprieve for Medicaid expansion

Dozens of healthcare providers and organizations urged the federal government Wednesday to grant Arkansas officials' request for two years to come up with a new Medicaid expansion model.

The federal Centers for Medicare and Medicaid Services verbally denied a five-year extension of the Arkansas Health and Opportunity for Me, or ARHOME. The Department of Human Services has not yet received a formal notification of the denial, nor has it received a response to the agency's request for the two-year grace period, DHS spokesperson Gavin Lesnick said Thursday.

"We recognize that the federal Medicaid landscape has changed and that Arkansas must respond to those changes," the organizations wrote in Wednesday's letter. "Granting this extension would not alter that reality. It would provide the state the time requested to make the transition thoughtfully and responsibly."

The letter, organized by the Arkansas Medical Society, was signed by an array of providers and groups including the Arkansas Hospital Association, the University of Arkansas for Medical Sciences and the American Heart Association.

Two years is "a reasonable and prudent request," especially since the more than 200,000 ARHOME recipients would retain coverage during that time, the letter from the 51 organizations said.

The Trump administration's rejection of renewing Arkansas' hybrid expansion spawned from new guidance under last year's One Big Beautiful Bill Act regarding budget neutrality, which requires states' Medicaid expansion programs to not cost the federal government more than would be projected without the program.

If the state is not granted its requested two-year grace period, all ARHOME recipients can be moved to fee-for-service coverage Jan. 1, though this change would be "disruptive" and "bumpy," DHS Secretary Janet Mann told lawmakers Monday.

Mann said the agency is "considering everything but ending" Medicaid expansion. In 2013, Arkansas became the first Southern state to adopt the program under the Affordable Care Act and the first state to use private insurance to expand Medicaid coverage.

The state can transfer ARHOME enrollees to fee-for-service Medicaid coverage or managed care, and the majority-Republican Legislature is expected to take up the matter in the session starting in January.

The One Big Beautiful Bill Act put in place work requirements for Medicaid expansion recipients that Arkansas will start enforcing Jan. 1. In the letter sent this week, the groups noted that starting a new Medicaid delivery system at the same time "could divert attention and resources from those [work requirement] implementation efforts."

Other health advocacy groups that signed the letter include Arkansas Ambulance Association, Arkansas Rural Health Partnership, Arkansas Pharmacist Association and the Little Rock Black Nurses Association of Arkansas.

Several hospital systems also signed, including Arkansas Children's Hospital, St. Bernards Health Care, Conway Regional Health System, Ashley County Medical Center, Baptist Health and DeWitt Hospital.

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