An Act For The Department Of Human Services - Division Of Medical Services Appropriation For The 2025-2026 Fiscal Year.
Summary
SB33 is the annual appropriation act for the Arkansas Department of Human Services (DHS), Division of Medical Services, for fiscal year 2025-2026. It authorizes funding for the division’s regular operations, extra help, salaries, operating expenses, and data processing, and it sets the maximum number of employees the division may employ. The bill also appropriates large grant and program amounts for Medicaid-related services, including ARKids B, hospital and medical services, prescription drugs, private nursing home care, public nursing home care, and smaller line items for the Child and Family Life Institute and Infant Infirmary.
In addition to core operating and grant funding, the bill sets aside money for nursing home closure costs, long-term care facility receivership expenses, and nursing home quality grants. It also includes special language governing Medicaid rate-setting methodology, requiring rates to follow CMS-approved methodologies and subjecting rate methodology changes to prior approval by the Legislative Council or Joint Budget Committee. Other special provisions restrict DHS spending on advertising and navigator-related activities for the Arkansas Health Insurance Marketplace and Arkansas Health and Opportunity for Me, require a set-aside for community and employment supports under the Medicaid waiver for individuals with intellectual and developmental disabilities, and mandate monthly reporting on Medicaid trust fund distributions and balances.
Impact
SB33 primarily affects state budget authority rather than substantive program eligibility or benefit law. It establishes the legal spending limits and staffing caps for DHS Division of Medical Services and authorizes more than $10.4 billion in Medicaid and related grant appropriations, along with smaller appropriations for long-term care oversight and quality initiatives. The bill also temporarily directs how certain funds may be used, including a $37.6 million set-aside for home- and community-based disability services and a $2.1 million retention mechanism tied to Arkansas Children’s Hospital supplemental Medicaid payments. Its special language also constrains DHS’s ability to use appropriated funds for marketplace promotion and navigator funding, and it requires legislative oversight of Medicaid rate changes and monthly trust fund reporting.
Sentiment
The bill appears to have been broadly supported and noncontroversial in the legislature. The recorded floor votes were overwhelmingly favorable, including a unanimous 34-0 Senate third reading vote and an 87-2 House third reading vote. No committee transcripts were provided, but the voting pattern suggests strong bipartisan acceptance of the annual Medicaid appropriation and related administrative provisions.
Contention
The main points of potential contention are not about whether DHS should be funded, but about how the funds may be used. The bill restricts advertising and enrollment-promotion spending for Arkansas Health Insurance Marketplace and Arkansas Health and Opportunity for Me, and it limits funding for navigators and related enrollment assistance, which could be opposed by supporters of broader outreach and enrollment efforts. Another possible area of debate is the requirement that Medicaid rate methodology changes receive prior approval from the Legislative Council or Joint Budget Committee, which preserves legislative control but may reduce administrative flexibility. The set-aside for community and employment supports and the hospital-related retention provision may also draw attention because they direct funds to specific providers or service categories.