This week on “Arkansas Week,” state health care leaders and lawmakers discuss the current condition of Arkansas’s health care system.
Our Featured Panelists
- Rep. Lee Johnson, physician, chair of budget committee
- Rep. Ashley Hudson, attorney, health care regulatory work
- Chancellor Dr. C. Lowry Barnes, University of Arkansas for Medical Sciences
- Jodiane Tritt, Executive Vice President, Arkansas Hospital Association
- Ray Hanley, Former Arkansas Medicaid Director
Last week, the University of Arkansas for Medical Sciences (UAMS) announced a partnership with Jefferson Regional Medical Center in Pine Bluff, with a mission to expand healthcare access across Southeast Arkansas. The partnership comes as hospitals across Arkansas face broader questions about financial stability, access to care and the future of Medicaid coverage.
The 2026 Arkansas Hospitals Economic Impact Report examines the financial pressures facing hospitals across the state, including uncompensated care, low reimbursement rates, and reduced access to medical services. For this week’s episode, host Steve Barnes discusses the relationship between these issues and the administrative decisions regarding healthcare finances with those close to the issues.
“We just finished in the black for the first time in a number of years.” … “Unfortunately, that’s not very far in the black for an institution our size. It costs us $6.7 million a day to keep our doors open.”
– Dr. C. Lowry Barnes, UAMS
To help decipher unfamiliar jargon surrounding these topics, we have provided a list of definitions, legal summaries and recent news that we will reference in our program. We hope you will find it useful, informative, and educational.
Useful Terminology
Private/Commercial Insurance
Coverage purchased directly from an insurance company, typically offered through the Health Insurance Marketplace or through private insurers. This type of insurance is frequently purchased by businesses and provided to their employees as part of an employment benefits package.
Public Insurance
Coverage provided by the federal, state or local governments, using taxpayer funds. Medicare and Medicaid are major public health insurance programs in the United States.
Health Insurance Subsidies
Federal financial assistance, determined by income, family size and health insurance costs in a user’s area. Subsidies can:
a. Lower a user’s monthly health insurance premium, or
b. Act as cost sharing reduction (a discount of sorts on out-of-pocket expenses during an insurance policy period).
Medicaid Reimbursement
Money paid to medical care providers on behalf of the insurance user for medical services included in the user’s Medicaid plan.
“If you’re not financially viable, you do things like cut labor and delivery.” … “And I think we’re going to see more and more of that if we don’t really rein in the reimbursement mechanisms and improve them.”
– Jodiane Tritt, Arkansas Hospital Association
Healthcare Programs Affected
Centers for Medicare & Medicaid Services (CMS)
The federal agency that provides health coverage (Medicare, Medicaid, Children’s Health Insurance Program, Health Insurance Marketplace). CMS operates under the federal Department of Health and Human Services (HHS).
Medicare
Provides “health insurance for people 65 or older who meet citizenship or residency requirements.”
Medicaid
Health insurance coverage for “eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.”
The Affordable Care Act (ACA)
Also known as “Obamacare,” a healthcare reform law created in 2010. According to HHS, the ACA is intended to “make affordable health insurance affordable to more people” by providing consumers with subsidies, “support innovative medical care delivery methods designed to lower the costs of health care,” and “expand the Medicaid program to cover all adults with income below 138% of the federal poverty level.” (see “Arkansas Hybrid Expansion Program”)
“You don’t not get sick or not get hurt if you don’t have coverage.” … “Some of the hospitals, frankly, are not going to survive.”
– Ray Hanley, Former Arkansas Medicaid Director
Arkansas Hybrid Expansion Program
Originally signed into state legislation as the “private option” via the Healthcare Independence Act of 2013, the hybrid expansion program “uses Medicaid dollars to buy private health insurance” (primarily Blue Cross Blue Shield or Ambetter). The “private option” was renamed “Arkansas Works” with the integration of work requirements in 2016, which were then amended in 2021 with rebranding as the “Arkansas Health and Opportunity for Me” program, or “ARHOME.”
To qualify for ARHOME, an individual must be between the ages of 19-64, not pregnant or eligible for Parent/Caretaker Relative, not eligible for Medicare, and have an income limit of 133% of the federal poverty level. The individual is eligible up to an effective 138% FPL once the standard 5% income disregard is applied.
In Recent News
Budget Neutrality Policy
Medicaid.gov has announced that as of Jan.1, 2027, CMS may not approve a Medicaid demonstration project (under section 1115 of the Social Security Act) unless:
“Chief Actuary of CMS certifies that such project is not expected to result in an increase in the amount of federal expenditures compared to the amount that such expenditures would otherwise be in the absence of such project.”
Budget neutrality was introduced by way of Public Law 119-21 of the Working Families Tax Cut, or “WFTC,” Section 71118.
Work Requirements for Health Insurance
The Big Beautiful Bill Act, signed into law by President Donald Trump on July 4, 2025,
Implements “as a condition of eligibility for medical assistance” … demonstration of “community engagement.” An individual demonstrates community engagement if they complete at least 80 hours of work or community service monthly or are enrolled half-time in an educational program.
Update on the Medicaid Expansion Program
Earlier this year, the state issued a request to extend the ARHOME program from its expiration date on December 31 through to the end of 2031. Federal officials have verbally denied this waiver, raising concerns for the program’s over 200,000 enrollees.
While we were filming this week’s episode, The Arkansas Democrat-Gazette announced that the DHS requested a two-year extension waiver for ARHOME to aid a smooth transition into a new expansion program. Federal response to this request has yet to be publicized.
“We’re not going to abandon 200,000 Arkansans to no health insurance. We’re going to figure out a way to provide them Medicaid.”
– Rep. Lee Johnson
Learn More
Nearly 40 employees furloughed as Ouachita County Medical Center navigates bankruptcy (KATV).
Find past episodes, links and resources mentioned at our website.
How To Watch
Tune in to “Arkansas Week" Fridays at 6 p.m. and watch again on ATV-1 Saturdays at 5 p.m., Sundays at 9:30 a.m., and Mondays at 6 p.m. Watch anytime on demand at our YouTube channel. Watch live online at https://www.arkansastv.gov/watch.