Expansion of Medicaid coverage in Arkansas

The Arkansas State Board of Health adopted a resolution at its quarterly board meeting July 26, supporting the expansion of the Medicaid program to cover individuals and families earning up to 133 percent of the Federal Poverty Level. The resolution was proposed by board member Clark Fincher, MD, FACP.

Fincher said, “Opting out of the Medicaid program expansion places an economic burden on hospitals and other health care providers who will not be reimbursed for services they may provide. One of the major challenges in improving the health of Arkansans is the fact that almost 600,000 of a population of 2.9 million have no insurance coverage. They cannot afford to pay for healthcare themselves. Providing basic services to these citizens consumes a great deal of the state’s resources. It places the burden of payment for care on institutions like hospitals and health care providers, who must, by law, provide very expensive care when Arkansans present to hospitals and emergency rooms with urgent needs and no insurance. This does not lead to good quality care.”

It is estimated that an additional 250,000 Arkansans would be covered under this Medicaid expansion. The program will be 100 percent federally funded for the first three years gradually scaling back to 90 percent in 2020. Currently, the State assumes 30 percent of Medicaid costs, so there is a huge potential for the State to realize substantial savings. Based on conservative estimates, the Arkansas Department of Human Services estimates that this Medicaid expansion would create a net savings of $89 million for the first full year of implementation and a net savings to the State of $372 million over seven years.

This large influx of funds can boost employment, stimulate the State’s economy, be of benefit to health care providers and hospitals and actually increase state and local revenues. Emergency rooms will be less crowded as patients seek care prior to emergent health needs at their Medicaid primary care physicians, thus, allowing more timely and cost-effective care to those who truly need to use emergency rooms.

Fincher also cited a survey released yesterday in the New England Journal of Medicine in which states that voluntarily expanded their Medicaid program over the last decade had mortality rates over 6 percent lower than neighboring states.

He said, “If Arkansas does not accept expansion of the Medicaid program, the state will still bear the financial burden through federal taxation to pay for the program for states that do participate, thus, paying the bill without receiving the benefit.” Further, Fincher noted that for a state that currently has the strictest standards for Medicaid eligibility, “Arkansas stands to gain the most.”

“In order to protect the health of all its citizens, especially those most in need, and to promote the fiscal soundness of the health care system in Arkansas, the Arkansas State Board of Health strongly urges the State of Arkansas to participate in the expansion of the Medicaid Program under the Patient Protection and Affordable Care Act.”