DHS submits request for temporary ARHOME waiver extension
LITTLE ROCK – The Arkansas Department of Human Services (DHS) has formally submitted a request for a two-year extension of the Arkansas Health and Opportunity for Me (ARHOME) waiver that expires at the end of this year in order to provide sufficient time to develop a new delivery system for Medicaid expansion in our state.
Secretary Janet Mann sent a letter on Aug. 5 seeking the extension following discussions with the Centers for Medicare and Medicaid Services (CMS) in recent days. CMS has signaled it will support efforts to ensure a smooth transition, and DHS looks forward to productive discussions on the extension in the near future.
“The ARHOME waiver will not be renewed in its current form, but this does not mean that Medicaid expansion is ending or that we will lose enhanced funding,” Mann said. “Coverage will continue for eligible ARHOME enrollees beyond Jan. 1.”
The full text of the letter is below.
CMS determined that the pending ARHOME waiver renewal will not comply with the new budget neutrality rules taking effect next year because of the 2025 federal budget law.
That decision does not end Medicaid expansion in Arkansas or have any impact on eligibility, and no action from beneficiaries is necessary at this time. It does mean that changes centering on service delivery will be necessary. DHS expects this to be a significant focus of the 2027 Legislative Session. There is not a need for a special session before then because CMS will either grant the extension, or DHS will continue coverage for ARHOME beneficiaries through existing statutory authorization
“We look forward to robust discussions with a wide range of partners as we develop a new delivery system for this program in a way that is functional, practical, and sustainable,” Mann said. “While it’s too early to know specifics of how this new approach will look, our commitment to connecting eligible Arkansans to effective health care will remain our guiding principle at the core of this work.”
The ongoing discussions on the future of the ARHOME service delivery model have no bearing on the implementation of community engagement and work requirements for the expansion population, which entered a soft launch on July 1 and will transition to a full launch with penalties in place for non-compliance starting Jan. 1, 2027. This requirement will apply to Arkansans aged 19 to 64 enrolled in ARHOME unless they are in an exempt category like pregnant and postpartum women, disabled veterans, caregivers, and those with special medical needs. Full details on this program are posted at ar.gov/engage.
Also separate from the changes to the waiver, Centene announced last month that it has decided to end its participation in ARHOME starting in 2027. DHS will provide additional information on next steps in the near future.
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