I said this morning and still believe that all the talk about Medicaid is a waste because Republicans won’t go for it.

Nonetheless, Arkansas Advocates for Children and Families has a report out on a favorite Republican talking point — requiring co-pays for the dirty scumsuckers who want government to help them pay for health care for their children and other human beings.

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Reasonable co-pays, particularly those that encourage cost-effective treatment, are possible. But they can also discourage cheaper alternatives, leave providers holding a financial bag and generally discourage better health care.

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.”

Jo Lynne Varner, clinic administrator at Little Rock Pediatric Clinic, says the state needs a system that will make being a Medicaid provider more attractive.

“Shifting more of the cost to families will have the net result of cutting provider reimbursement,” Varner says. “Many of those families cannot pay the copay, but providers are still obligated to provide services, knowing there is no mechanism for enforcement. Historically, medical bills are the last priority for families. In bankruptcy situations, healthcare providers rarely see any return.”

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