Legislators Mull Risk Private Option Poses To Community Health Centers

Jul 25, 2013

The chief operating officers for several community health centers at a legislative hearing Thursday.
Credit Michael Hibblen/ KUAR News

Community health clinics, which provide services to the neediest Arkansans, are objecting to one aspect of the private option.

At a hearing Thursday, the leaders of several clinics told state lawmakers that a waiver included in the plan will cut into reimbursements so deeply that some won’t be able to stay open.

But some Republicans dispute whether they will indeed be affected.

The community health clinics are reimbursed at a higher rate than other providers because they’re required to offer services to everyone, regardless of whether they have coverage. There are 83 sites in Arkansas located in underserved areas.

Allan Nichols, CEO of Mainline Health Systems, told members of the Public Health Committee that a waiver included in the private option legislation, approved during this year’s legislative session, will cut deeply into their budgets.

“We want to serve. We’re not here to file lawsuits. We’re not here to do that. We want to serve people, that’s it. And we’re very fragile. We’re non-profits with very, very thin margins that cannot sustain bumps in the road,” Nichols said.

“If bumps happen, I can list the names of the communities that get to suffer those bumps. I can list the names of the providers that won’t be here for those bumps. For me, this right here has the projection of 20 out of my 65 people will go away. Two of my six sites will disappear and it’s just absolute because they operating at such a thin line that it’s just not possible to take a hit.”

Some legislators disagreed on whether revenue for the centers would be at risk.

Representative John Burris (R-Harrison) argued that under the private option, patients in need of the care would be placed under a separate funding designation.

In a testy exchange with Sip Mouden, CEO of Community Health Centers of Arkansas, Burris questioned whether a legal challenge might be filed.

“I’ve had about 10 people talk to me about a lawsuit and you say it has never been discussed. Is that the case?”

“Yes sir, that’s the case.” Mouden replied.

“So you’re willing to promise us you won’t sue,” Burris asked.

“I’m willing to tell you that my board of directors will direct me on what to do and we’ve not discussed a lawsuit,” Mouden said.

“So the answer is no, you will not say you won’t sue,” Burris persisted.

“They have to tell me what they’re going to do,” Mouden said.

“I understand, it’s just aggravating,” Burris concluded.

John Selig, director of the Department of Human Services, said after the hearing that community health centers serve as a safety net, particularly in rural areas. He’s confident a solution can be reached to everyone’s satisfaction.

“One of the things we want to do is make sure they’re not unduly harmed by this, so we’re going to look at ways to do that, kind of put some protections in place,” said Selig.

“I think what we’re going to do is ask for the waiver we’re talking about, but then ask for a pool of funding that, if it’s necessary for that to be tapped, we can tap that.”

Meanwhile Selig says the state is on track to file its application for the private option with the federal government on August second. He hopes to get approval by October.

The private option would use federal Medicaid money to pay for private insurance through an exchange as part of the federal health care law.