The Arkansas state legislature advanced a proposal Monday that would slash Medicaid payments to assisted living facilities that provide services to the elderly and individuals with disabilities — a move that continues the state’s assault on the public health insurance program designed for low-income people.

Lawmakers advanced the legislation in a joint meeting of the House and Senate public health committees, choosing to move forward even after a variety of providers and individuals who rely on assisted living spoke out against the proposal.

“I’m coming here today to beg you to have a heart and get rid of this [proposed] system, because I’m afraid it’s not going to allow enough hours [of care] to meet the needs of the disabled community,” said Ann Ledgerwood, according to the Arkansas Democrat Gazette. Ledgerwood was speaking on behalf of her 37-year-old son Bradley, who has cerebral palsy.

The Department of Human Services proposal would impact nearly 9,000 Arkansas residents who rely on the ARChoices Medicaid program, which provides home services to seniors over the age of 65 and adults between the ages of 21 to 64 who have a physical disability.


According to the Northwest Arkansas Democrat Gazette, the proposal could lead to the shutdown of the nearly 100 assisted living facilities in the state that accept Medicaid patients. It could also force people with disabilities to rely on nursing homes, which are more expensive.

Already, two assisted living facilities in the state have signaled that they are in danger of closing due to the proposed cuts.

The move to cut funding to assisted living centers continues the state’s efforts to limit Medicaid growth in order to meet Republican Gov. Asa Hutchinson’s stated goal of saving $835 million in program funds over a five-year period.

The proposal also comes on the heels of Arkansas’ approval of Medicaid work requirements last spring, which has, so far, resulted in loss of health coverage for more than 12,000 low-income Arkansans.


As ThinkProgress previously reported, Arkansas has dropped more than 60,000 people from its Medicaid rolls over the past two years, according to figures from August. At the time, Hutchinson told the Arkansas Times this decline was due to the state’s strong economy.

“I would emphasize that this is not a change in services. This is simply the result of people that are working,” he said.

But Monday’s proposal would, in fact, result in a change in services, cutting payments to assisted living facilities by approximately 22 percent and enforcing an annual cap of $5,000 to $30,000 on per person ARChoices services, depending on the severity of an individual’s needs. Those currently receiving more than $30,000 in services would be able to maintain the care through 2019.

While Gov. Hutchinson pushes for reductions in Medicaid spending that would hurt the poorest and most vulnerable Arkansans, he has simultaneously proposed cutting personal income taxes that overwhelmingly benefit the richest in the state, a move that “would result in the loss of nearly $200 million ($192 Million) in annual state tax revenue,” according to Arkansas Advocates for Children and Families.

Arkansas is not alone in its proposed changes to Medicaid. A similar proposal was recently implemented in Montana, where the Department of Public Health and Human Services cut Medicaid reimbursements to nursing homes and assisted living facilities to address a budget shortfall. Over the summer, a group of nursing home and assisted living facilities sued the state over the cuts.

And last year, Senate Republicans introduced several versions of a measure that aimed to reduce more than $770 billion in Medicaid funding — a proposal that would have hit nursing home beneficiaries especially hard. The Senate ultimately rejected the bill.