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Pending Waivers:• Arkansas Senior Rx 1115 Waiver: to establish prescription drug coverage, up to twoprescriptions per month, for non-institutionalized elderly at up to 90 percent FPL. Thiswaiver is currently on hold.• Arkansas Employer Sponsored Insurance Initiative: a HIFA waiver, which wasscheduled to begin on July 1 2003, to provide health insurance coverage to an additional55,000 residents of the state of Arkansas with incomes at or below 200 percent of thefederal poverty level, using SCHIP funds, state general revenue (employer taxescalculated based on the size of the business) and cost-sharing. The waiver ispending. 303Other Health Insurance Reforms/InitiativesDespite its history as a state with a high percentage of low-income individuals, low levels ofemployer-sponsored insurance, low Medicaid coverage for adults, and relatively poor healthstatus, Arkansas has more recently been noted for its pursuit of coverage expansion. Arkansas’Medicaid expansion, ARkids B, which expanded eligibility to currently uninsured childrenthrough age 18 with family income at or below 200 percent FPL, has been considered aconsiderably progressive initiative. There is no presumptive eligibility although retroactiveeligibility extends three months back. The application process mirrors that of Medicaid, may bedone by mail, and is only renewed every 12 months. There is no asset testing for Medicaid orARkids B. The eligible child must not have had insurance other than Medicaid in the prior sixmonths (unless it was lost through no fault of the applicant). ARkids B includes a reducedbenefit package and operates as a fee-for-service primary care case management model.Since the establishment of ARkids B, the state has sought several additional expansion waivers,described above: the Senior Rx waiver, the Medicaid Employer Buy-In waiver, and theEmployer-Sponsored SCHIP buy-in waiver.A component in the success of Arkansas’ expansion efforts appears to be the Arkansas Centerfor Health Improvement, a joint project of the Arkansas Department of Health and the Universityof Arkansas for Medical Services created to provide support for state and local policydevelopment and implementation. 304ColoradoState DemographicsColorado had an estimated population of 4,550,688 in 2003. 305 This is a 35 percent increase inpopulation since 1990. Thirty percent of Coloradans have incomes below 200 percent of thefederal poverty line (FPL), with 13 percent below 100 percent FPL. 306 More Coloradans haveprivate insurance than the national average. Fifty-eight percent have employer-based insurancecoverage, and 6 percent have individual coverage. Regarding public assistance, Colorado’spercent coverage is slightly lower than the national average with 11 percent covered byMedicaid, SCHIP or other public insurance (including dual eligibles with Medicaid and Medicare)and 9 percent covered by Medicare. Seventeen percent of Coloradans are uninsured. 307State Fiscal EnvironmentColorado has a unique fiscal environment because of two tax and expenditure limitations (TELs)that have been written into the state constitution: 1) Article X, Section 20, called the Taxpayer’sC-19