Arkansas sees results with Medicaid innovation

When it comes to government programs, often the first question many of us ask is “Are we getting what we’re paying for?”

Given the significant federal and state tax burden that each of us carries that’s a reasonable question to ask. And if the answer is “no”, then it’s up to policymakers to make the necessary changes to make those programs more effective and more accountable to taxpayers.

As someone who has spent considerable time working on issues related to our state’s Medicaid program, I’m happy to say that we’re on the right track. It’s been almost four years since Arkansas modernized our Medicaid program to a public/private partnership, with private insurers providing healthcare coverage to roughly 300,000 additional Arkansans under the Arkansas Works program. Because of changes made back in 2013, Arkansas has driven a decline in our state’s uninsured rate from 15% to 9%.

And the impact on Arkansans in rural areas has been even more significant. According to a new study by the Rural Health Policy Project, Arkansas is one of the states with the greatest decline in the percent of uninsured adults in small towns and rural areas, falling from 29% in 2008-9 to 16% in 2014-15. Those are tremendous gains in coverage in rural Arkansas, where access to healthcare can be especially difficult. Not only does this increased coverage provide families with greater access to vitally needed health services, as researchers noted, “it also protects the entire family against medical debt, bankruptcy and improves economic security.”

But the success of Medicaid is measured by far more than statistics. Across the state, people who had struggled to afford a trip to the doctor or a prescription refill are finally getting consistent treatment. Our friends and neighbors are feeling better, and they are grateful for it, and our healthcare providers are benefiting from increased financial stability.

What’s most rewarding is to know that disadvantaged children are healthier and on track for a greater success because of Medicaid. Getting screened for common issues, like scoliosis and tooth cavities, and receiving any treatment they need makes a big difference — not only in their immediate physical health but also their academic performance and lifetime incidence of disease.

In my book, that means Arkansas Medicaid is working.

Conservatives have long argued that public good can be done without an intrusive welfare state. Arkansas has now proven it with our Medicaid solution. Policymakers leveraged flexibility and innovation to develop an effective Medicaid program that works for our state. And with reforms recently passed during the 2017 legislative session, we will soon see the implementation of a new model in which healthcare providers and insurers are working together to provide improved and more efficient care to vulnerable patients from the traditional Medicaid program.

Our version of Medicaid involves private healthcare companies in service delivery, incentives to achieve more for patients at a lower cost, and financial requirements for able-bodied adults who participate in Medicaid to encourage personal responsibility. There has also been a consistent focus on spending, so Medicaid doesn’t crowd other important things out of the state budget down the road.

I commend my colleagues in the Legislature and Governor Asa Hutchinson for working through the details and never settling for less than Arkansas deserves. There are new improvements and modifications planned, but Arkansas Medicaid is already a success story and has other states calling to find out how it’s done.

Being on the cutting-edge is a reason for pride, but we can’t become complacent. Right now, it’s essential that Congress and President Trump continue to grant us the leeway and the funding to keep up the good work. That’s a message I’ll deliver loud and clear at every opportunity.
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Editor’s note: Rep. Aaron Pilkington, R-Clarksville, a health clinic administrator, is the author of this essay. Opinions, commentary and other essays posted in this space are wholly the view of the author(s). They may not represent the opinion of the owners of Talk Business & Politics.