- Associated Press - Wednesday, April 13, 2016

LITTLE ROCK, Ark. (AP) - Arkansas lawmakers barreled toward a budget standoff over the state’s hybrid Medicaid expansion as they began their legislative session Wednesday, with opponents showing little sign of retreating from their push to defund the program.

The Joint Budget Committee advanced the Medicaid budget bill funding the expansion, which uses federal funds to purchase private insurance for more than 250,000 people. The Senate planned to vote Thursday on the proposal, but supporters acknowledged they’re likely shy of the 27 votes needed to approve the budget.

“Nothing’s real until the vote occurs, and I think it’s important to do that on the front end,” Senate President Jonathan Dismang said.

The vote comes less than a week after lawmakers by wide majorities approved Republican Gov. Asa Hutchinson’s plan to keep and rework the program, which was created three years ago as an alternative to expanding Medicaid under the federal health law. Hutchinson has proposed new restrictions, including a requirement that some participants pay premiums.

The plan has sharply divided Republicans who control both chambers of the Legislature, with opponents casting it as an embrace of the federal health law GOP officials have called for repealing. Opponents of the expansion proposed Wednesday a cap on enrollment in the program and termination of the expanded coverage by year’s end, an approach that appeared unlikely to win the votes needed to even be considered.



“There’s very few paths here: someone changes their vote to vote for the appropriation, the governor changes his mind and convinces a majority of the Legislature to change their mind or we just go to a shutdown of (Medicaid),” said Republican Sen. Bart Hester, who opposes the expansion. “I think number three, I don’t think anyone’s interested in that.”

Opponents who had been pushing for the expansion’s funding to be considered separately said they’re prepared to vote against the entire Medicaid budget.

“I’m not going to vote for an appropriation that includes Arkansas Works,” said Republican Sen. Scott Flippo, referring to the name for the reworked expansion. “I just believe it’s bad policy.”

Hutchinson said he’s not open to considering any changes to his hybrid Medicaid expansion plan to assure the funding bill’s passage.

“It got a huge majority, a majority of Republicans and a majority of Democrats,” Hutchinson told reporters. “That policy issue has been resolved. The time to change policy is not during the appropriation process.”

Hutchinson also singled out some Senate opponents of the program, criticizing Republican Sen. Bryan King for opposing the Medicaid budget after telling a newspaper in his district that he’d like to see some funding increases for the Department of Human Services. Hutchinson and legislative leaders have warned that state agencies across the board will face significant cuts without the expansion.

“My question to Sen. King is, do you want us to follow his admonition to the district and increase funding for foster care or do you want us to listen to his message here in Little Rock that it’s easy to cut, no problem cutting DHS?” he said. King dismissed the criticism.

“To try and paint Bryan King as (sending) mixed messages, he’s being a lawyer and not a leader,” King said.

House Democrats, meanwhile, said they oppose taking up any other budget bills until the Medicaid expansion’s future is resolved.

“To sit here and take votes on budgets or appropriations that may ultimately have to change because of this, we don’t think that’s responsible,” House Minority Leader Michael John Gray said.

House Speaker Jeremy Gillam said legislative leaders are considering briefly recessing the session if the Medicaid budget bill stalls in the Senate. Gillam said he’s confident there are more than the 75 votes needed in his chamber to pass the funding bill, but said a break may be needed for opponents to talk to constituents about the consequences of ending the expansion.

“Their folks may say, look, we’re not asking you to hold up government and shut everything down,” Gillam told reporters.

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Follow Andrew DeMillo on Twitter at www.twitter.com/ademillo

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