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Medicaid can now help with at-risk pregnancies

By submitted, 11/5/22 7:57 AM

LITTLE ROCK – Arkansas received good news from federal regulators that allows the state Medicaid program to better help women during at-risk pregnancies and other at-risk populations.

Last year Medicaid provided medical services to 12,500 Arkansas women with high-risk pregnancies.

The availability of more benefits will extend also to veterans aged 19 through 30, and to people in rural areas who have been diagnosed with a serious mental illness or a substance abuse disorder.

Another group that will benefit are young people from 17 through 27 years of age who have been in foster care, young people 19 through 24 who have been incarcerated and young people aged 19 through 24 who have been in the custody of the state Youth Services Division.

State Medicaid officials had asked for permission from federal agencies to implement the new services, targeted at some of the state’s most vulnerable people.

The permit came in the form of a waiver for the Arkansas Medicaid expansion program known as ARHOME. At the beginning of September ARHOME had 339,297 enrollees.

The waiver allows ARHOME to emphasize services for specific vulnerable populations, and as a result Arkansas residents will hear a lot more about Life360 HOMEs, the name of the newly designed programs.

Maternal Life360s will serve pregnant women. Rural Life 360s will serve people in rural areas suffering from mental illness or substance abuse. Success Life 360s will help young people who have been in foster care, jail or the juvenile justice system. Also, it will serve young veterans at risk of being homeless.

Hospitals coordinate a variety of services that enrollees receive. For example, they will provide a nurse to visit the homes of pregnant women, during their pregnancies and for up to 24 months after the baby is born. They will get funding for counselors to help people with mental illness, and to set up acute crisis units.

Acute care hospitals can contract with local organizations that have experience working with young people at risk of leading a life of poverty. Those youths typically go through foster care and the juvenile justice system.

People receiving services under the Life360 may be referred to homeless shelters, churches or faith-based organizations.

The state’s Medicaid expansion program has had several names since its initial creation. It was called the private option when the legislature first approved it in 2013.

Unlike the traditional Medicaid program, the private option and subsequent versions uses government funds to subsidize private health insurance for eligible people.

The second version of Medicaid expansion was called Arkansas Works, because it first had a requirement that in order to receive services an enrollee must either work or look for work.

An individual with income of more than $12,888 a year must pay a $13 monthly premium to help cover the cost of ARHOME health insurance. Medicaid pays the rest. Also, enrollees must pay up to $60 a quarter in co-pays.

Co-pays are generally $4.70 for a doctor visit. Generic medications are $4.70, and specialty drugs are $9.40. There are no costs for some services, such as preventive care and vaccines.