HJAR Nov/Dec 2020

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2020 55 LaShannon Spencer Chief Executive Officer Community Health Centers of Arkansas If COVID-19-positive cases and deaths continue to increase, alarming rates of job- less workers and households with devastat- ing income losses may result. The need for Medicaid coverage could grow. Many people may not realize that essential workers are often enrollees in anACAMedicaid program. Those who qualify for such services in Ar- kansas are beneficiaries through Arkansas Works. Nevertheless, these individuals risk losing their coverage due to a change in the political balance at the Supreme Court. Yet, in states like Oklahoma and Missouri, where voters recently approved Medicaid expansion, there is a growing awareness of the importance of using the tools of gov- ernment to improve individual and public health. States have the latitude to develop their own Medicaid programs as long as they cover core groups and services. Programs range from fee-for-service reimbursement run by state agencies to managed care ad- ministered by commercial insurers. The ACA’s Medicaid expansion gives states the option to insure all adults up to 138 percent of the poverty line. The federal government covers more than 90 percent of the expan- sion group’s cost, which is more generous than the 50 to 83 percent match for other Medicaid-eligible groups. The ACA also requires states to streamline administra- tion, imposing new mandates to improve beneficiary service. In early 2021, many states will be prepar- ing for their upcoming legislative sessions. With states beginning to exhaust options to avoid budget cuts, more states could poten- tially slash Medicaid unless public health advocates stand up and resist such efforts. In Arkansas, our state elected officials will likely again debate whether to continue Ar- kansas Works. Astrong Medicaid program is vital for Ar- kansas. Medicaid is a crucial health coverage source for workers in essential or front-line industries (people such as hospital workers, home health aides, food manufacturers, gro- cery store workers, farmworkers, bus driv- ers, truck drivers and warehouse workers). Many low-income workers in these jobs are not offered job-based coverage or simply can’t afford the premiums. The ACA also gives small-business own- ers access to health insurance. Over the last decade, employer health insurance premi- ums and deductibles have outpaced an in- dividual’s wage. This is concerning, because it often puts small-business owners in a dif- ficult situation—do they offer insurance at higher premiums or cut staff to keep the premiums affordable? But, let’s keep inmind how bad things were before theACA. Many businesses couldn’t afford to offer health insurance at all, and many employees were simply priced out of the market. Others couldn’t even get basic coverage because of pre-existing conditions. We cannot allow politics to cause Americans, especially Ar- kansans, to lose healthcare coverage. It will cause a ripple effect and shutter the doors to our safety net providers. Thanks to the ACA and Arkansas Works, CHCs across the state have provided more than just healthcare services. They offer care in a patient-centered delivery manner—a holistic approach to improving health out- comes. Providers in CHCs focus on the whole person, including addressing the social determinants of health and empow- ering patients to be partners in their health outcomes. In the end, regardless of what happens in Washington, let us, as healthcare leaders and policy leaders, be united under one voice to bring positive innovation to our healthcare system in Arkansas to improve the health of our state and its people. Elected officials, public health professionals and healthcare leaders must keep focused on creating in- centives and develop innovative solutions to improve the health of all Arkansans. n With states beginning to exhaust options to avoid budget cuts, more states could potentially slash Medicaid unless public health advocates stand up and resist such efforts. ”