Proposed expansion of Medicaid in Arkansas in about more than serving all those additional people in need.
Helping them ought to be reason enough for state lawmakers to give the idea strong consideration. But lawmakers may listen more to voices other than the 250,000 Arkansans who could be newly eligible for Medicaid, if they ultimately agree to expand the program.
Take, for example, the people involved in the delivery of health care services. These folks maintain a presence in the halls of the state Capitol and carefully watch legislation that could affect them and their patients.
Expansion of Medicaid clearly does, as illustrated by support for the change by groups like the Arkansas Hospital Association and others impacted by the inability of many Arkansans to pay for their care.
Many of the state’s working poor, the largest contingent of the people who would benefit from Medicaid expansion, are otherwise uninsured. They still get sick and hurt and must have care.
Hospitals often provide them services without compensation and the rest of us help pay the tab through higher health insurance rates.
Bo Ryall, president of the Arkansas Hospital Association, recently put the figure for uncompensated health care at hospitals at $338 million a year. Obviously, the hospitals would like to be paid for services they provide and expansion of Medicaid would help cover that cost while easing the load on their emergency rooms. That’s where people with no insurance inevitably land, frequently sicker than they would have been if they had coverage and could have sought help earlier.
As Ryall noted, hospitals and others are lobbying their legislators to encourage expansion of Medicaid. All over the state, hospital administrators, nurses and others involved in health care are talking to their representatives, trying to get them to see this proposal as more beneficial than not. They are, of course, making the case for better care for these uninsured Arkansans, but they’re also arguing the practical side of taking the federal dollars to expand the program.
Theirs are the voices to which lawmakers might ultimately listen. While the state’s poor have some able advocates speaking for them with lawmakers, there are many more others with a stake in the expansion decision.
This ongoing debate was triggered by congressional approval of the Affordable Health Care Act, which provided for nationwide expansion of Medicaid to a larger segment of the nation’s poor and disabled.
The expansion was originally intended to be mandatory, but the decision to expand or not has instead been left to the states as a result of a U.S. Supreme Court ruling.
Importantly, the cost of expansion will be borne entirely by the federal government for the first three years. Later, the state would pay a percentage of the cost, up to a maximum of 10 percent, under provisions of the existing federal law.
If Arkansas opts not to expand Medicaid, the money that would have insured this state’s people will go elsewhere.
Gov. Mike Beebe, a Democrat, has endorsed Medicaid expansion and will push for it in the upcoming regular session of the Legislature. But approval will require a three-quarters vote in the House of Representatives and in the Senate, both of which now have Republican majorities.
Medicaid will be expanded only if enough of them can agree that there are more benefits than costs to the decision.
Right now, there are strong differences of opinion among lawmakers on this issue of expansion. They need to hear some persuasive arguments to get on board with the idea. Or they’ll never find that three-fourths vote to make it happen.
BRENDA BLAGG IS A FREELANCE COLUMNIST AND LONGTIME JOURNALIST IN NORTHWEST ARKANSAS.