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Committee rejects bill to expand assisted‑living Medicaid waiver after DHS cost estimate
Summary
SB577 would have removed a point‑in‑time cap and set a 1,550 unduplicated cap for an assisted‑living Medicaid waiver; DHS estimated a worst‑case Medicaid impact of about $9.4 million (federal $6.7M, state GR $2.7M). Industry groups and Alzheimer's Association supported the expansion; the committee voted and the measure failed.
Sponsor presented Senate Bill 577 to expand Arkansas' Medicaid assisted‑living waiver by eliminating a point‑in‑time cap and establishing a minimum unduplicated cap of 1,550 waiver slots. Industry witnesses said the current slot constraints harm rural access and that assisted living generally costs less than nursing‑home care.
Todd Hightower of HealthMark Services told the committee the sector faces a "big shortage of assisted living Medicaid slots" and that when the prior cap was reached, roughly 63 people remained waiting at the time the program reopened. Ed Holman of Retirement Services of Arkansas said assisted living is "under attack from every direction" and argued expanding slots would save money compared with nursing‑home placement. David Cook of the Alzheimer's Association submitted statistics and urged support to expand access as the number of Arkansans with Alzheimer’s grows.
Mark White of DHS explained program mechanics, noting the waiver historically had both a point‑in‑time cap (1,200) and an unduplicated annual cap; recent changes kept the point‑in‑time cap at 1,200 while increasing the unduplicated cap. White told the committee that eliminating the point‑in‑time cap and requiring a minimum unduplicated cap of 1,550 would have a worst‑case fiscal year impact of "just over $9,400,000" to Medicaid; he said the federal share would be about $6,700,000 and state general revenue about $2,700,000, but called that a worst‑case assumption because churn makes that unlikely.
Committee members questioned whether expanded waiver slots could inadvertently push assisted‑living operators out of the market or increase nursing‑home placements; DHS said it had not completed an apples‑to‑apples analysis of those displacement costs. After closing remarks from the sponsor and a roll‑call, the committee recorded that the bill failed to pass.
Next steps: Sponsor said the bill "may be brought back" and thanked members; no immediate motion to refile was recorded.
