Cost-sharing and copayments reduce access to health care for low-income families who already struggle to make ends meet. In the debate to extend Medicaid to 250,000 adults, the idea of using some form of cost-sharing or copayment system has come up again and again. The federal government allows considerable state flexibility with implementing cost-sharing. However, a new report by Arkansas Advocates for Children and Families (AACF) says copayments can create barriers to access to care.

The report, "The Facts on Medicaid Copayments: Considerations for Arkansas," says copayments can also harm health care providers. Those providers lose out on income when Medicaid enrollees can't afford to pay their co-pays.

Anna Strong, health policy director at AACF, says incentivizing health care providers and patients to use cost-effective, preventive care can help improve outcomes and save money.

"There are better ways to lower costs while giving patients a stake in their health care," Strong says. "For example, structuring copays to encourage prevention and discourage unnecessary care can reduce costs and improve outcomes. We think those efforts will be more rewarding for Arkansans than imposing across-the-board copays that folks struggle to afford. People need access to health services, and providers should get paid for those services too."

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