Advocates are looking ahead to the 2025 legislative session with community, healthcare, and economic policy in mind. Arkansas Advocates for Children and Families (AACF) hosted the 2024 Children's Policy Symposium Tuesday.
Executive Director Keesa Smith-Brantley opened the morning encouraging attendees to engage with their representatives.
“However you are sending a message to legislators to let them know what is important to you, it is important for your voice to be heard,” Smith-Brantley said. “That is what our country is based on.”
She added without making intentional efforts to speak with legislative officials, some groups are at risk of being forgotten. She said she recently spoke with a group of medical professionals who didn’t think their voices would be heard by legislators.
“Many of them were rural providers who rely heavily on Medicaid. And they said ‘do you think folks are understanding in Little Rock understand how important Medicaid is to keeping rural hospitals open?’ and I said ‘I think they do, but what would help is if you are equally raising up that issue, and that they hear from a group of doctors, physicians, and dentists saying that those things are important.’”
One of AACF's top priorities is getting the state to pass an expansion to Medicaid to cover mothers for 12 months after giving birth. Arkansas is the only state in the U.S. that has not expanded Medicaid access to 12 months postpartum. The state’s current plan only covers people for 60 days after giving birth.
Camille Richoux is the Health Policy Director at AACF. She says rejecting the expansion–and arguments that the current 60-day expansion is enough–is only hurting new mothers.
She shared the story of a woman named Maya whose coverage changed after delivering twins at 25 weeks through a cesarean section. Richoux said when Maya tried to schedule follow-up appointments to continue care for ongoing liver and gallbladder issues, she was “back to square one.”
“[Maya] talked about spending hours on the phone trying to get in touch with someone. She had an emergency surgery–well not emergency but emergent surgery canceled to get her gall bladder removed, which is part of the reason why she had to have the emergency C-section. She experienced postpartum depression, she lost coverage and access to her postpartum mental health specialist because they were no longer in network,” Richoux said.
So far at least two legislators have filed bills proposing expanding medicaid coverage for a year postpartum, one by Rep. Andrew Collins, D-Little Rock, another by Rep. Aaron Pilkington, R-Clarksville.
“We’re going to get 12 month postpartum coverage passed,” Richoux said. “There’s just no other option. We have to get it done.”
Another of AACF’s healthcare priorities is to expand presumptive eligibility for pregnant mothers, meaning individuals who seem eligible would no longer have to wait months for approvals.
“Waiting longer for prenatal care can delay both routine health issues that are exacerbated during pregnancy, and also pregnancy related care itself,” Richoux said.
According to Richoux, DHS has plans to implement presumptive eligibility at some medicaid offices, but she said legislation is still important.
“If you’re already doing it there should be no problem with the law,” she said. “We are going to continue making sure it’s implemented fairly and across the state uniformly.”
AACF’s other priorities for the 2025 session include expanding access to contraception, supporting the maternal health workforce, and implementing Medicaid reimbursement for doulas.
“Having all those support systems, those wraparound services during pregnancy and then in that postpartum period are extremely valuable to improving maternal and child health outcomes.”
Peter Gess is the Economic Policy Director at AACF. He gave an overview of the state budget process, noting Arkansas has built in checks at multiple levels to hold legislators accountable.
“It is very much focused on control and accountability, very centralized with lots of steps, lots of checks. And that’s good right, because this is public trust, this is the public’s resources, so we want to make sure it's spent at least how it’s allocated, even if we disagree sometimes on how it's allocated,” he said.
He highlighted changes to the general revenue fund, which functions as the state’s discretionary fund. Gess said Arkansas general revenue fund has fallen significantly, from making up 27% of the state budget two years ago to only 16% in the 2024 fiscal year.
Gess says this is largely due to tax cuts passed by legislators over the last ten years. He said he still has questions about what will happen to services typically funded by the general revenue budget if legislators continue to phase out the income tax.
“The official message so far out of the administration is that ‘well when we reduce income tax more corporations and more people move here, to live in Arkansas and to work in Arkansas.’ We have not seen that play out yet.”
Gess also voiced concerns the current legislature will not be as critical of the budget as in years past.
“There's been a worry in Arkansas in recent years, that the legislature is not maybe living up to its constitutional duty to actually review, change, address the budget, and, is rather basically railroading through whatever the governor proposes.”
The 2025 legislative session begins in January.
