Like most health policy folks, I have been watching developments in my home state of Arkansas with much interest.  Recent media reports have discussed interest among state leaders to use Medicaid to purchase plans on the exchange, also known as the marketplace that will make private insurance available to many uninsured Arkansans starting next year as part of the Affordable Care Act. There are no doubt pluses and minuses to this approach, and we have all been waiting for more details.

Today, some of these details came to light with a troubling turn.  Among other concerns, the state Department of Human Services memo outlines plans to move children in ARKids First to the exchange to be covered with their parents.

I will be the first to acknowledge the benefits of an entire family being covered on the same plan—we often tout the benefits of whole family coverage—but making this change now when so little is known about the new marketplace and how affordability and benefits will be protected is, to put it mildly, risky.

ARKids First is the result of a strong bipartisan commitment to children’s coverage and a nationally recognized gem for the state. It is popular, not to mention hugely successful.  As my colleagues at Arkansas Advocates for Children and Families can tell you, it has driven the rate of uninsured children in the state to historic lows (6% in 2011, according to AACF’s latest data) and provided security and peace of mind to thousands of families who wouldn’t otherwise have affordable health coverage for their children.

Like other states, Arkansas is in a furious race to get the marketplace up and running by the beginning of 2014.  Meanwhile, much about this new exchange—how it will operate, provide access to needed services and achieve affordability—is still not entirely clear.  It holds promise for thousands of uninsured Arkansans, to be sure, but many unknowns remain.

Now is not the time to experiment with kids and mess with what we know is already working.  This may be an important policy consideration down the road, when it’s clear how well the exchange works for adults, but to move these kids now would be short-sighted.  Doing this today could cause many children to fall through the cracks, meaning the state could jeopardize the substantial progress that it has made, thanks to ARKids First, in getting children the coverage they need.