Loss of Medicaid affects Miller County children

Federal funding was abundant during the COVID-19 pandemic.

States across the union were able to rely on the national government to supply them with financial aid while they contended with the virus locally.

That assistance has lessened, and the financial decrease is affecting medical treatment for the underserved in Arkansas. States received federal funding to help those on Medicaid keep their insurance during the pandemic, but following the conclusion of the federal emergency, states re-evaluated Medicaid eligibility, leading to a large unwinding of Medicaid enrollees.

“Because individuals may have moved, changed phone numbers, divorced, married, had children, or otherwise changed their circumstances, they may have missed efforts to reach them to update information and renew their eligibility,” Executive Director of the Arkansas Chapter of American Academy of Pediatrics Anna Strong said. “After a period of time, Medicaid had to remove them from the program if they had not received updated information.”

This led to a dramatic shift in health care coverage. In Miller County, Arkansas, alone, more than 2,500 children could be affected by the crackdown on Medicaid eligibility, according to statistics from the Arkansas Department of Human Services.

Rachel King, co-owner and physician at King Medical Clinic in Ashdown, Arkansas, said her clinic has seen a 25% decrease in Medicaid reimbursement for medical care since the policy changes took effect.

“At King Medical Clinic we have lost approximately 20% of our enrollees during this time frame,” she said. “This has definitely led to fewer wellness checks and sick visits.”

Additionally, the fact that King Medical Clinic is not owned by a larger medical group has made the losses more acute from a financial perspective. More than 500 children could be affected by the Medicaid changes in Little River County, where King’s office is located.

Strong said the situation has led to multiple instances of poorer health care results for Arkansans.

“We have heard stories about people having had less-than-optimal outcomes, given the gaps in health coverage. Health insurance helps protect families from catastrophic expenses and helps ensure that the cost of preventive care, screenings and sick visits/hospitalizations are controlled,” she said.

More than half of Arkansas children have historically relied on Arkids First for their health coverage since Gov. Mike Huckabee extended that option to more children in 1997, according to Strong. The loss of insurance can also lead families down a path of making tough financial choices for multiple facets of their lives.

“When left uncovered, families can be put in the position of deciding between unexpected medical expenses and rent, food or other basic necessities,” she said. “A study of a large 2005 Medicaid disenrollment in a neighboring state showed that eviction filings increased by 27%. Medical debt is a leading cause of bankruptcy for families, and without insurance coverage … .”

The lapse of insurance also leads families to be less proactive in keeping up with preventative care, which can have long-lasting consequences for children.

“In any patient population, preventative care is essential to living a happy and healthy life,” she said. “Well-child checks help address developmental, physical health and mental health concerns before they become a larger problem. If patients do not have insurance coverage, this leads to poor health outcomes.”

And this decrease in coverage can have long-ranging impacts, including a financial effect on hospitals as fewer people take preventative care measures.

There are no concrete numbers for the time period since the unwinding, but it is common for actions like this to have a negative impact on area medical centers, said Jodiane Tritt, executive vice president of the Arkansas Hospital Association.

“Often, hospitals experience a delayed impact — although at a heavier price — when patients lose coverage,” she said. “When patients suddenly can’t get their prescriptions or can’t access routine care, it might cause more acute illness that could land them in the emergency department. Or they might be left with the emergency department as their only choice for where to seek non-emergent care.”

At King’s facility, receptionists and administrative staff work diligently to check insurance coverage and viability for their patients.

“When a patient is found to be without coverage, we call the parents/guardians and let them know,” she said. “We also provide them with the resources like their local DHS office to get coverage reinstated.”

Even with her staff’s efforts, there is only so much that can be done, and insurance coverage is vital to the success of children in her community. There have been many instances — ranging from broken arms to acquiring antibiotics to treating pneumonia — that were put off for far too long because the patient lost their Medicaid insurance, according to King.

“When families know that health care may come with a huge price tag, they are less likely to seek care in a timely way,” Strong said. “Additionally, pediatric providers have shared stories about patients who didn’t know they had lost coverage during the unwinding and were unable to get needed medications, therapies or other services that help them stay well at school and at home.”

There is help for those who have lost coverage, though. Strong said families who have seen their medical insurance lapse can get re-enrolled at no cost or on a sliding scale. Any Arkansan who wants to know the status of their Medicaid coverage can go to Access.arkansas.gov, she said. And those who do not qualify for fully funded Medicaid can explore additional coverage options at Myarinsurance.com.

At a macro level, it will take legislative action to provide a comprehensive solution to the Medicaid unwinding. The General Assembly’s schedule can make policy action difficult, so Strong’s organization has focused on a more grassroots effort to help those with a lapse in coverage re-enroll.

“We have focused recently on letting families know about existing coverage options so they can get care now,” she said. “We have also worked with health care providers to ensure that they are reaching out to those patients who lost coverage to ensure they get reconnected to coverage.”

Additionally, Strong’s organization is coordinating with Kid’s Fest Texarkana to reach out to families and educate them on their insurance status.

“Festivals like this provide great grassroots opportunities to help people understand the enrollment and re-enrollment process, provide additional information about coverage options, and answer questions on how they can ensure their families have health care coverage,” she said.

And although legislative action would be helpful, Strong said ultimately it’s up to families to take action right now and make sure they’re covered and protected.

“Right now, the next steps rest with families who have lost coverage. We need them to take action, not necessarily the Legislature,” she said. “Arkansans who may have lost coverage have a few options, some of which are run here in Arkansas (ARHOME, Arkids First/medicaid) and some of which are part of health care. gov (My Arkansas Insurance). All of these options offer affordable, no-cost or low-cost plans to meet the needs of Arkansas families.”

Kids Fest Texarkana is scheduled for 10 a.m. to 6 p.m. Saturday, May 18, in Front Street Festival Plaza downtown.