Summary of HB1004

Bill Information:

• Bill Number: HB1004
• Sponsors: Representative Pilkington and Senator B. Davis

Current Policy:
Under current law, postpartum Medicaid coverage for mothers in Arkansas is limited, typically lasting up to 60 days after childbirth unless the mother qualifies for extended coverage through specific programs like the Arkansas Health and Opportunity for Me (HOME) Act.

Proposed Changes in HB1004:

• Extend postpartum Medicaid coverage for eligible mothers to one year after giving birth.
• Coverage would be delivered through:
  • The Arkansas Health and Opportunity for Me (HOME) Act for mothers enrolled under this program.
  • The traditional Arkansas Medicaid program for mothers not enrolled in the HOME Act.
• The Arkansas Department of Human Services would be responsible for:
  • Securing federal approval by submitting a state plan amendment or waiver.
  • Promulgating rules necessary to administer the extended postpartum coverage.

This bill seeks to provide continuous healthcare access to postpartum mothers for one year, improving maternal and child health outcomes in the state.

Nationwide Context:

1. States Expanding Postpartum Coverage:
   As of 2024, at least 40 states and Washington, D.C. have opted to extend postpartum Medicaid coverage to one year. Some states, like Illinois and California, have already reported improvements in maternal health outcomes since implementing the extension.

2. Arkansas's HOME Act Connection:
   Arkansas's HOME Act was created to reform Medicaid and provide healthcare access to more residents. HB1004 aligns with this framework, using existing structures to expand postpartum care.

Historical Context

Similar legislation has been proposed in Arkansas in recent years to extend Medicaid coverage for postpartum mothers:

• 2021 Legislative Session: During the 93rd General Assembly, House Bill 1759 was introduced to expand Medicaid postpartum coverage from 60 days to 12 months. This bill aimed to provide continuous healthcare access to new mothers throughout the first year after childbirth. However, the bill did not advance to become law.

  AR Advocates

• 2023 Legislative Session: Representative Aaron Pilkington introduced House Bill 1035, which sought to require medical providers attending a birth to inform mothers about Medicaid coverage options and the importance of postpartum care. While not directly extending coverage, it focused on improving awareness and utilization of existing services. This bill also did not become law.

  ScholarWorks

Despite these efforts, as of late 2024, Arkansas remains the only state that has not extended Medicaid postpartum coverage to 12 months, nor has pending legislation to do so. Governor Sarah Huckabee Sanders has expressed opposition to such an extension, suggesting that existing programs should be optimized instead.

The introduction of HB1004 in the 2025 Regular Session represents a renewed effort to address this issue by proposing a direct extension of Medicaid postpartum coverage to one year, aligning Arkansas with the majority of states that have adopted similar measures to improve maternal health outcomes.

Differences between HB1004 and HB1008

Both HB1008 and HB1004 propose extending postpartum Medicaid coverage to one year after giving birth, but they differ slightly in their implementation details.

Similarities:

1. Purpose: Both bills require the Arkansas Department of Human Services (DHS) to extend Medicaid coverage for postpartum mothers to one year after childbirth.
2. Federal Compliance: Both direct DHS to take necessary actions, such as applying for state plan amendments or waivers, to secure federal approval.
3. Rulemaking: Both require DHS to promulgate rules to implement the extension.

Key Differences:

HB1008 (Representative A. Collins):

• Simple Extension: This bill focuses solely on extending Medicaid coverage for postpartum mothers to one year without specifying how the coverage is to be administered beyond the basic Medicaid framework.
• Broad Application: The bill applies to all eligible mothers uniformly, without distinguishing between different Medicaid delivery systems.

HB1004 (Representative Pilkington, Senator B. Davis):

• Arkansas Health and Opportunity for Me (ARHOME) Act Reference:
  • If a mother qualifies under the ARHOME Act of 2021, the extended postpartum coverage is delivered through that program.
  • If a mother does not qualify under ARHOME, coverage is provided through the traditional Medicaid program.
• Targeted Approach: This bill creates a dual-path structure to deliver coverage based on a mother’s specific eligibility under ARHOME.

Layman’s Terms Summary:

• HB1008 is a straightforward bill that simply extends postpartum Medicaid coverage to one year for all eligible mothers without specifying delivery methods.
• HB1004 adds an extra layer of detail by specifying how coverage is delivered:
  • Mothers eligible under the ARHOME Act get coverage through ARHOME.
  • Others get coverage through traditional Medicaid.

Both bills aim to achieve the same goal but differ in how they integrate the extended coverage into Arkansas's Medicaid system.