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Medicaid Expansion Through Premium Assistance: Arkansas, Iowa, and Pennsylvania’s Proposals Compared

Arkansas, Iowa, and Pennsylvania have proposed implementing the Affordable Care Act’s (ACA’s) Medicaid expansion by using Medicaid funds as premium assistance to purchase coverage for some or all newly eligible Medicaid beneficiaries in Marketplace (formerly called Exchange) Qualified Health Plans (QHPs). Arkansas and Iowa’s § 1115 demonstration waivers have been approved by the Centers for Medicare and Medicaid Services (CMS), and Pennsylvania’s application is pending with CMS. This fact sheet compares the states’ proposals.