This year, Arkansas Advocates for Children and Families engaged in a Medicaid story collection project with grant funding. Our goal was to amplify the lived experiences of those within the Medicaid population (applicants, enrollees, and providers). We sought out diverse stories throughout the state, and focused on highlighting stories from historically excluded populations, including the Marshallese community; African American/Black communities throughout the central, Delta, and southern areas of the state; and Hispanic/Latino communities. Higher rates of health disparities persist within these populations due to exclusion from full rights, privileges and opportunities within the health care and other systems in our society. Our story collection was achieved through the rich partnerships AACF has cultivated with organizations in the state of Arkansas. We were able to reach parents, people impacted by serious health conditions, individuals with disabilities, individuals affected by mental illness, and older adults. Arkansans were excited to be able to share what Medicaid has meant to them personally.

Positive Impact of Medicaid

There were many key takeaways from the stories presented to us. The most important of them being that Medicaid has helped so many Arkansans throughout the state receive life-saving medical care.

Medicaid has been a great help to me. When I had a lot of problems with the VA as a veteran, Medicaid came in so I was able to see doctors and get medication. Sometimes you have to wait months to see a doctor at the VA but you just can’t wait. Medicaid saw that I get doctor visits when I need them and medications right away with no out-of-pocket expenses.

Edward

I look back on my life and what has transpired, and I thank the Lord that I had the opportunity to have Medicaid. Medicaid cuts down on stress, and It’s a peace of mind knowing that everything is available to me. That is an all-around win for me.

Ovetta

… They impact me and my family , for the services we need. Medicaid has provided transportation to doctor’s appointments… I am able to go and see my doctor, eye doctor, dentist, a lot of it, Medicaid pays for.

DS

It was like a miracle. I was able to go to the doctor, be seen by any doctor.

Celeste

Medicaid is critical in helping to identify and provide treatment for developmental disabilities in children.

Karen

Without Medicaid, clients would have an extremely short life span.

Faith

Areas of Concern for Current Medicaid Participants

Along with  praise of the Arkansas Medicaid Program, Arkansans expressed areas of concern that should be addressed to better meet the health needs of all.

Sometimes my medicines are too high which means I don’t have as much money for other things we need.

Jeremaine

I can’t always pick up my medication because I always have to pay a fee even though I have both Medicaid and Medicare.

Shirley

Summit [Arkansas PASSE] does not want to cover his medication; however, he can not go to school without it. As a result, I have to fight every six months with health insurance to get prescriptions through Summit on time and to prevent my son from running out of medication.

Amy

The hardest part was applying for it. It was a lot of paperwork.

BW

They need to change how they do medicine and prescriptions and set it on a person’s conditions not just set on everyone having the same thing. Some people’s conditions are worse and some people have way more prescriptions to get filled than others. Like me, I do, I have to pay extra every month for my prescriptions. It’s hard. I can’t even get stuff for my household because I am taking all the money I do raise.. and it put it towards my medicine and stuff.

Kandis

So It can change with, for one, the availability slots that we get when we are trying to get back and forth to the doctor’s office. There are not enough available slots for us to be able to go to the doctor throughout the year.

Valencia

It’s good to have some form of medical insurance, but it is hard when you get denied a lot of treatment and medications. Each time a physician prescribes a medication that is working, then Medicaid won’t pay for it.

Windell

Right now, I am dealing with pain because Medicaid will not pay for me to see another specialist until next month.

HT

Importance of Necessary Policy Changes

What this project has pointed out to our organization is that there is continued advocacy needed for children, families, and other vulnerable populations throughout the state. Many Arkansans are experiencing difficulties in attaining adequate care due to limitations for appointment, prescription, and transportation slots.

Nearly 1 in 4 (24%) Americans taking prescription medication say that it’s difficult affording their medication. Participants of this project stated that it was difficult to balance household expenses and their prescription costs. This sometimes resulted in participants forgoing necessary medication because they did not have the money to purchase it. 

Medicaid currently limits the number of doctor visits for adults 21 years or older. There is the possibility of increasing those visits, but it is not guaranteed. This is problematic for many communities of color where higher health disparities exist and individuals are affected by multiple health conditions. It is also significant because these communities have been historically excluded from access to health care services. Black Americans have greater health morbidity and mortality at every age. Hispanics have an 80% higher rate of diabetes compared to non-Hispanic whites. They also have higher rates of obesity than non-Hispanic whites, which plays a role in the development of chronic health conditions. Marshallese living in the United States have a high prevalence of cardiometabolic comorbidities such as type 2 diabetes. They also have a higher rate of infectious diseases such as tuberculosis and leprosy. Due to these health concerns within these populations, it’s important that they have access to appropriate levels of care. Increasing the allotment of approved appointments will allow all Arkansans to be able to receive the appropriate level of treatment for their varying health concerns.

There have also been difficulties in Arkansas’s Marshallese community in the processing of applications for newly eligible Marshallese adults. Community members experienced differential treatment due to language barriers with Medicaid programming staff members. Language is a critical component to improve access to quality health care for communities with limited English proficiency. Since there is such a large population of Marshallese within Arkansas, it would be beneficial for the Department of Human Services to work in conjunction with local advocacy organizations in the Marshallese community. A partnership could be developed to assist Marshallese families with Medicaid application processing. Many adults expressed a need for dental coverage due to the expensive out-of-pocket costs that can result from dental procedures. Research has shown that oral health and overall wellness are closely related. Failing to address oral health conditions can have a negative impact on overall health. Individuals’ physical and oral health should be given the same level of importance.

Where AACF Goes From Here

Going forward, Arkansas Advocates for Children and Families is committed to centering our advocacy initiatives on the following areas to improve healthcare access for all Arkansans:

• Presumptive eligibility for children and pregnant women
• 12-month postpartum coverage for new mothers to address the maternal mortality and morbidity crisis in Arkansas
• Increased appointment, prescription, and transportation slot allotments to improve access to medical care
• Improved/expedited processing of individuals within the Marshallese community; contracting with community providers in the Marshallese community to aid in processing applications to avoid application delays and problems with communication between agency and community members
• Dental coverage for all Medicaid recipients with an increased allotment of coverage 
• Increased SNAP allotment for low-income adults/older adult populations with subsidized housing

Improvements to the Arkansas Medicaid Program will only strengthen the health outcomes for Arkansans. It will provide more Arkansans with life-changing and life-altering treatment to individuals in need. Medicaid expansion has been essential in Arkansas, and increased expansion to cover necessary treatments will benefit the health of our state.