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House committee approves 12-month postpartum Medicaid expansion using CHIP HSI funds
Summary
The Public Health, Welfare and Labor Committee passed House Bill 1004 as amended to extend postpartum Medicaid coverage to 12 months for eligible Arkansas women by using CHIP HSI funds to cover the state share, a funding approach sponsors say will require no new state dollars.
State Representative Aaron Pilkington, the sponsor of House Bill 1004, told the House Public Health, Welfare and Labor Committee that the bill would extend postpartum coverage to 12 months for women up to 200 percent of the federal poverty level and that Arkansas is currently the only state that has not made that extension. Representative Aaron Pilkington, District 45, said Arkansas had seen coverage gaps that warranted action: “The most recent report actually showed that that's now increased to 4 out of 10 women in Arkansas.”
The amendment adopted before the committee hearing directs the state to use a portion of Children’s Health Insurance Program (CHIP) Health Services Initiative (HSI) funds to cover the state share of the extended postpartum benefit. Pilkington said the amendment is intended to make the extension cost neutral for the state: “This approach is a cost neutral to the state requiring no new state dollars. The CHIP HSI fund has plenty of available funds for this.” He also explained the bill includes an auto-enrollment mechanism where appropriate to limit duplication and improve matching rates for coverage.
Three witnesses gave in-person support. Mackenzie Foreman, a licensed certified social worker and owner of Holding Space Counseling, testified about maternal mental health consequences when coverage lapses: “Medicaid coverage too often ends abruptly creating dangerous gaps in care.” Latoya Morgan, an educator in the Little Rock School District, described a personal loss she said was tied to gaps in postpartum care and urged committee members to approve the bill. Ben Washington, who identified roles with the Arkansas State Legal Justice Center and the Arkansas Public Policy Panel, said the proposal would help rural and vulnerable communities and repeated the sponsor’s cost-neutral characterization.
Committee members asked how federal approvals would be handled. Representative Bentley asked whether a waiver was required; Pilkington and witnesses confirmed the plan requires federal approval and that the state Department of Human Services would need to coordinate with the Centers for Medicare & Medicaid Services (CMS) and HHS. Pilkington said the bill’s design — using HSI funds and preserving existing eligibility rules — was meant to reduce duplication and fiscal impact.
After closing remarks by the sponsor, the committee approved a motion to pass House Bill 1004 as amended by voice vote. The chair declared the bill passed and moved it forward in the process.
Why it matters: Supporters framed the measure as closing coverage gaps tied to poor maternal outcomes and greater risk of untreated perinatal mental health conditions. The sponsor and witnesses emphasized the change would not require additional state general revenue because it relies on a permissible use of existing CHIP HSI funds.
What the committee did next: Committee members advanced the bill to the next legislative stage with the amendment that authorizes use of CHIP HSI funds to fund the state share if federal approvals are secured.
