- Associated Press - Saturday, December 19, 2015

LITTLE ROCK, Ark. (AP) - A task force formed to study the future of Arkansas’ hybrid Medicaid expansion gave Gov. Asa Hutchinson the bargaining chip he wanted as he starts negotiating changes to a program covering more than 200,000 people. The panel avoided, however, giving a definitive answer about the expansion’s future or where to find up to $60 million a year in annual cuts from the overall Medicaid program.

The Health Reform Legislative Task Force’s vote to support Hutchinson’s negotiations stopped short of endorsing specific restrictions the Republican governor has proposed. Still, Hutchinson is casting the decision as a way to show federal officials he has the Legislature’s unified support as he makes the case for overhauling the “private option” expansion and renaming it “Arkansas Works.”

“I’m not asking for a 5-4 vote,” Hutchinson said, alluding to split U.S. Supreme Court decisions on the federal health law that spawned the expansion debate here and nationwide. “I’m asking for a strong vote that demonstrates to Arkansas that we understand where we need to go as a state and that we’re ready to take the next step in pursuing the waivers as outlined in Arkansas Works.”

With no objections heard during the voice vote, Hutchinson received the near-unanimous support he requested. That kind of backing will be harder to come by as he begins hashing out the details of the expansion.

Hutchinson acknowledged the challenges he faces within his own party with his call to keep the hybrid expansion, which uses federal funds to purchase private insurance for low-income residents. It was crafted as an alternative to expanding Medicaid under the federal health law that Hutchinson and other Republicans deride as Obamacare.

Hutchinson rode that wave to the Governor’s Mansion last year, in a race where he regularly tried to cast his Democratic rival as enabling the health overhaul’s passage. Urging lawmakers to give him a green light to pursue his plan, Hutchinson acknowledged the political difficulties he may face in embracing a key part of a law he’s criticized.

“If you look at other southern governors and other southern states, the position I took was contrary. The position I took bears some political risk,” Hutchinson said. “But at the same time I saw it as the right thing to do for Arkansas.”

Hutchinson’s timeline for overhauling the program helps him avoid some of the political risk. He has said he wouldn’t call a special session until the spring - meaning the expansion’s future won’t come up for a vote before a March 1 primary that will feature several Republican contests defined by the expansion debate.

He also faces resistance from Democrats, who are wary of the restrictions he wants to add to the program in his bid to win support from Republicans. Democrats are concerned about the asset test Hutchinson wants to add to the program, which they say could harm beneficiaries who may have a home but no income to pay for health insurance. Hutchinson has acknowledged that he already faces an uphill fight in convincing President Barack Obama’s administration to agree to such a restriction.

But the panel’s vote leaves unresolved a bigger fight over Medicaid’s future. Lawmakers voted to identify the $835 million in savings Hutchinson says the state needs over the next five years to pay for its share the expanded coverage, with between $50 million and $60 million coming from state cuts to the program. That will largely hinge whether to have private companies manage some parts of the state’s Medicaid program.

The debate leading up to the panel’s vote last week focused primarily on the managed care question. Republican Sen. Jim Hendren, who co-chairs the task force, said that shows how lawmakers are facing questions much bigger than the Medicaid expansion.

“The real fight is where the real dollars are, and the real dollars are in the traditional Medicaid program,” Hendren said.


Andrew DeMillo has covered Arkansas government and politics for The Associated Press since 2005. Follow him on Twitter at www.twitter.com/ademillo

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