Spaulding said Medicaid expansion through the Arkansas Health Connection's "private option" has had a palpable effect on many people who have never had health insurance before. "Regardless of how you feel about it politically, it was expanded and there are thousands of people who are benefiting from it," he said, adding several of the newly insured have suffered with untreated chronic diseases for years. "The fact is, what has been done in Arkansas, it's created an opportunity for the overall health of the state of Arkansas to improve."
Medicaid expansion will be a financial bargain for the state even after the federal government tapers its support for the expansion program from 100 percent to 90 percent after 2020, Wroten said. "The economic benefit we will get from insuring all those people will more than offset the cost. In order to have a medical practice, you have to have enough patients with insurance or who can otherwise pay for care."
Arkansas officials face several remaining barriers in their quest to transform the state's healthcare system, including annual legislative votes on Medicaid expansion that require 75 percent majorities and convincing Medicare to join the state's new payment system.
"We need Medicare to join completely," Thompson said. "We're losing some of the fidelity of the signal to our providers."
The surgeon general said the top two candidates seeking to succeed Beebe, who is ineligible to run for re-election due to term limits, have "both signaled willingness to continue" the Payment Improvement Initiative, but he noted healthcare "is usually not the first choice" for any new governor.
"We're not at the home stretch yet," he said. "It still could go wrong."