- Associated Press - Saturday, April 9, 2016

LITTLE ROCK, Ark. (AP) - With clear majorities in both chambers of the Legislature, Arkansas Gov. Asa Hutchinson easily won support for his plan to keep and rework the state’s hybrid Medicaid expansion. His reward? The type of protracted, divisive fight over the program he’s sought to avoid and the prospect of an unprecedented shutdown of state government.

The Legislature’s approval of bills outlining Hutchinson’s proposed restrictions for the hybrid expansion are a preview of the debate he’s about to face with fellow Republicans who have vowed to block its funding.

Hutchinson and supporters of his plan are warning its opponents to not jeopardize the state’s Medicaid program, and potentially the overall state budget, over a proposal that less than a third of the Legislature opposes. The proposal passed with large majorities in the House and Senate last week, but still a handful of votes shy of the three-fourths support that the Medicaid budget bill funding it will need in the fiscal session starting this week.

“There’s a fundamental principle of government that we need to deal with, and that is that a minority should not derail the expressed will of the majority,” Hutchinson said as he signed the measures into law last week.

History offers Hutchinson and supporters of his expansion plan, dubbed “Arkansas Works,” plenty of encouragement. Ever since Arkansas’ hybrid expansion was created three years ago, the program has sharply divided Republicans and has led to threats of defunding from opponents who call it an embrace of the health overhaul.

But there are signs that, this time around, the fight could be tougher for Hutchinson, who successfully convinced lawmakers last year to reauthorize the program another year while a task force looked at its future. Hutchinson is hoping to sway a wing of his party that’s benefited from the anti-“Obamacare” message that’s made the GOP the majority, including several who made killing the hybrid expansion their central issue.

They’re also not shy about floating the possibility of a Washington-style government shutdown.

Republican Sen. Bart Hester, an outspoken opponent of the expanded coverage, said he doesn’t believe a shutdown will happen but said: “If that was the only way (to stop the program), and let me be clear I don’t think that’s the only way, but I would.”

Hester and other opponents are pushing for a separate vote on the program, which uses federal funds to purchase private insurance for more than 250,000 people. But Hutchinson and other backers are rejecting that idea, noting it’s historically been considered within the larger Medicaid budget and that lawmakers have already supported the program by large majorities in both chambers.

The prospect of being asked to vote against other Medicaid programs, including insurance for children and assistance for the disabled, is giving several opponents pause.

“It is a concern for those most-needy populations that we serve, no matter what decision we make on this expanded population,” said Republican Sen. Blake Johnson, who voted against the expansion plan.

The potential for a funding showdown comes more than a year after Hutchinson said he hoped to move beyond the divisive fights that marked the “private option” hybrid expansion that he inherited.

“The phrase ‘private option’ itself has become politically toxic, so much so that it’s almost impossible to have a constructive conversation about health care reform without passions rising and folks taking sides,” Hutchinson said shortly after taking office last year.

But that’s exactly the type of scenario laid out by Hutchinson, who noted that supporters of his program are just as unlikely to support a Medicaid budget without the expanded coverage as opponents are likely to push for it being stripped out.

“That’s what leads to government shutdowns in Washington. We’ve never had that in Arkansas,” Hutchinson said last week. “I don’t expect to have that under my watch. But those are the consequences that are real, and it’s real to tens of thousands of people in Arkansas who are dependent upon these services.”


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

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