Arkansas Senators Tom Cotton, a member of the Senate healthcare working group, and John Boozman have not given an indication that they would support health legislation projected to cut 22 million people off of Medicaid. Notwithstanding, a vote on the bill has been postponed due to divisions in the Republican Party.
Arkansas Public Media spoke with Sara Rosenbaum, a George Washington University professor and evaluator for the state of Arkansas's expansion program, about the possibility of an end to Medicaid expansion in Arkansas.
What would you expect if the expansion ended and that population became uninsured, what would you expect for those people?
Well, I mean, it will be devastating. It’s just, so much happens for people when they can get access to healthcare, and so I would assume that, you know, to the extent that these cuts cause the state to have to eliminate this program, the consequences to the state would be devastating.
Do you expect that many of those people who might be cut out of Medicaid could go into the regular exchange and use federal subsidies to get insurance that way?
Well, under the Senate bill, poor people would have access to the tax subsidies. The problem is the tax subsidies in the Senate bill are, quite frankly, ridiculously inadequate for people in poverty. People with incomes, you know, so low as to have virtually no income would still have to pay something for their insurance. Assuming that they could pay something for their insurance, the policies they would get would be much skinnier than the polices they get today. So there might be no mental health care, no maternity care, very little in the way of drugs, very little in the way of physician care. And the benefits would be subject to massive deductibles. So for these people, if you’re poor and you have a policy with a $7,000 deductible, it doesn’t mean anything.
What is the scope of Medicaid's use in a state like Arkansas? What facets of life does it enter into? What do people depend on it for?
Everything from well-child care, to well-women exams, breast cancer screenings, cervical cancer screenings, family planning services, routine health exams, which people might need for work, and then of course treatment for acute care problems, acute health conditions. And you know, all the way to treatment for the most serious conditions we know — heart problems, diabetes, cancer.
Are there any aspects of the Senate bill that you think would be a benefit to Arkansas?
No. I would say the Senate bill is without benefit to Arkansas. It so reduces the amount of funding available for Medicaid and for people who need tax credits in order to be able to afford insurance through the marketplace. It withdraws about $1.2 trillion, and that money is basically all re-purposed. Some of it is recaptured in grants to states, about a little over $100 million, but most is deficit reduction or tax cuts for wealthy people.
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*Editor's Clarification: Rosenbaum is part of a team of evaluators of Arkansas's expansion program. A previous version of this story referred to her as an "advisor."