Sen. Ingram says Medicaid expansion staved off hospital crisis, new factors causing concern

Sen. Keith Ingram, D-West Memphis, noted that a near decade of help from the state’s Medicaid expansion program has stabilized Arkansas’ health care system, but now a new set of circumstances is challenging hospitals’ financial health.

In an interview on Talk Business & Politics, the chair of the Senate’s Hospital and Medicaid subcommittee, said the private option, also known as Arkansas Works and ARHome, has been an effective “backstop” to guard against hospital closures, especially in rural parts of the state.

“The Medicaid expansion – Arkansas Works, ARHome – is going to be 10 years old in 2023. Without that backstop, we would’ve lost so many rural hospitals in Arkansas, like the states that surround us. They’ve had a tremendous amount of hospital enclosures. So what has happened is that staved off the financial crisis that other states have gone through until this point,” he said.

“What has brought this to a crisis is just what you talked about. The coronavirus pandemic has run costs up for everything from nursing to what they pay for supplies. So, in order for a state to be great, it’s got to have two things. It’s got to have a strong education system and it’s got to have a strong healthcare system. If you don’t have those two things, they’re sort of the DNA building blocks for economic development.”

For weeks, hospital officials in Arkansas have been sounding the alarm that several factors are impacting their finances and ability to provide services to patients. Ingram said one step to alleviating the brewing hospital financial crisis is raising Medicare and Medicaid reimbursement rates.

“My goodness, I think Medicare and Medicaid make up probably over 50% of the payer mix for our hospitals in Arkansas. And those rates have not changed since I think in 1992. And then that was a 5% discount. So, insurance rates, private insurance, has helped close that gap over the years, but where we really get into a problem with private insurance is in the rural areas where the payer mix might only be 10% or 15% of private insurance that helps offset those low Medicare and Medicaid rates. So those are going to have to be revisited,” he said.

Over the last decade, Arkansas has seen its adult uninsured population fall into the high single digits, thanks in part to Medicaid expansion. During his administration, Gov. Asa Hutchinson tried to attach a work requirement to qualification for the insurance program, but a federal court struck down the provision. Last week, a federal court in Georgia allowed that state’s Medicaid expansion program to keep a work requirement as a condition for qualification.

Could Arkansas see another run at a work requirement?

“It could,” Ingram said. “But the federal government, when that goes on appeal, I think that that precedent has been set before. That this is an entitlement, that we can’t put requirements on it. And the truth of the matter is ARHome [Arkansas’ current Medicaid expansion program], the vast majority of the people that are on it, are the working poor in the state. So I don’t see that. As a wise city attorney once told me, ‘you can pass any law you want until somebody challenges it.’ I think that loses on appeal to a higher court. And I don’t think that that’s going to be allowed.”

Ingram will retire at the end of 2022 after serving in the Arkansas Legislature since 2009. He was West Memphis Mayor from 1987 to 1994. The Senate Minority Leader said public service is something instilled in him from his family and he’ll find other ways to serve once he’s out of office.

“The one thing that I know is that you don’t have to be an elected official to serve your community. I did that before I was mayor. I was 31 when I was elected mayor. I was 39 when I chose not to seek re-election. And I didn’t run for [legislative] office until I was 54 or 55. So I’ve had gaps in public service, but my family, my father, mother, they were real believers in community and in community service. So I’m going to find a way to serve. You can bet that. It’s too ingrained in my DNA,” he said.

You can watch Sen. Ingram’s full interview in the video below.