Safety-net clinic providers in Arkansas are concerned that the state's plan to subsidize the insurance for hundreds of thousands of low-income residents could result in their payments being cut, reported the Arkansas News.
Arkansas is applying for a waiver from the Centers for Medicare & Medicaid Services to purchase coverage from commercial carriers for as many as 250,000 low-income residents in lieu of expanding its Medicaid program. Several other states resistant to Medicaid expansion, such as Florida and Nebraska, are considering a similar plan, which is known as the private option, reported Kaiser Health News.
In Arkansas, the waiver would allow the private insurers offering coverage within the exchange to negotiate rates with the state's safety net clinics. Many clinic operators fear the rates they demand will be lower than what Medicaid would pay.
According to Allan Nichols, the chief executive officer of clinic system operator Mainline Health, as many as two of its six clinics would have to close. It provides services to 165,000 state residents in medically underserved areas. "We're very fragile. We're nonprofits with very, very thin margins that cannot sustain bumps in the road," Nichols said during a recent joint legislative hearing in Little Rock.
However, John Selig, director of Arkansas' Department of Health Services, noted that many of the sickest patients at the clinics would be considered medically frail and would still remain enrolled in Medicaid, the Arkansas News reported.