HJAR Nov/Dec 2020

54 NOV / DEC 2020 I  HEALTHCARE JOURNAL OF ARKANSAS COMMUNITY HEALTH The Affordable Care Act, Creating Healthy Communities DIALOGUE COLUMN COMMUNITY HEALTH AS THE COVID-19 pandemic continues to affect many families, communities and our nation negatively, the future of healthcare remains unknown because of the recent death of Supreme Court Justice Ruth Bader Ginsburg. Justice Ginsburg’s death has triggered many conversations about possible changes to theAffordable CareAct (ACA). If a conser- vative supermajority on the Supreme Court strikes down theACA, at risk will be the prog- ress made by policymakers and stakeholders who have worked extremely hard to create healthy communities and protect those with pre-existing conditions. Without coverage, we could see a rise in chronic diseases. Primary care treatment could revert to emergency room settings. Preventative care will be nonexistent for many. Proactive discussions on addressing increase due to the unemployed losing their job-based health insurance because of COV- ID-19. According to theArkansas Department of Human Services, enrollment in Arkansas Works is up 34,724 people (13.4 percent) from February to September. When I think about the potential elimina- tion of ArkansasWorks, I immediately think about many consequences: the risk to safety net hospitals, the alarming rates of uncom- pensated care that will be borne by hospi- tals, the deteriorating financial stability of our healthcare systems and, closest to my heart, the potential slashing of services ren- dered by Community Health Centers (CHCs). People will worry about their ability to afford healthcare, especially those who have lost their jobs. Our Medicare patient population will fret about high deductibles and out-of- pocket costs for prescription drugs. “We have an opportunity to create a future where we are actually encouraging providers to keep people away from acute care, whenever possible.” —Kathleen Sebelius the social determinants of health will go by the wayside. Instead, we will be forced to fo- cus on urgent conditions and ailments as they occur. There will be less of a constructive effort to examine ways to improve access to healthcare services, to expand the afford- ability of healthy food and to increase op- portunities for physical activity—all of which are aspects of creating healthy communities. Governor Asa Hutchinson has a compas- sionate heart and makes every attempt to put the people first regardless of the politics. He understands the equation can be difficult at times but knows the importance of mak- ing our state healthier, thus improving our economy. Arkansas Works is just one factor toward the solution. Numbers for Arkansas Works— the Arkansas version of the Medicaid ex- pansion allowed by the ACA—continue to