- Associated Press - Thursday, June 29, 2017

LITTLE ROCK, Ark. (AP) - The U.S. Senate GOP’s stalled health care legislation needs to ease some of its limits on Medicaid spending and give greater control of the program to the states, Arkansas Gov. Asa Hutchinson said Thursday.

The Republican governor outlined changes he’d like to see in the legislation aimed at repealing and replacing major portions of the 2010 federal health overhaul. Hutchinson, however, stopped short of saying whether he opposes the measure if it doesn’t include the proposed changes. Senate leaders shelved a plan to vote on the legislation this week and are working on revisions to win enough votes to pass the measure.

“We’re not saying do nothing. We’re saying we need to do better and we need to have a better result from the debate in Washington,” Hutchinson said at a Capitol news conference.

Hutchinson proposed exempting the elderly, blind and disabled from a plan to cap federal Medicaid spending, saying the legislation as is would represent a major cost shift to the state of some of the program’s biggest expenses. About 950,000 people are enrolled in Arkansas’ Medicaid program, according to the Department of Human Services.

Hutchinson’s office said Arkansas could not cover the $200 million more needed per year to sustain the Medicaid expansion under the proposed legislation, which would reduce the enhanced match rates states receive from the federal government for the program. More than 300,000 people are covered under Arkansas’ hybrid expansion, which uses Medicaid funds to purchase private insurance for low-income residents.

The law setting up Arkansas’ hybrid expansion requires the state to wind down the program if the federal match is reduced.

Hutchinson called for the legislation to allow states to include the expansion population in a Medicaid block grant, which he said would allow the state to negotiate a better match rate for those on the expanded program than what’s currently laid out in the bill.

“If we do this, then the states can assume risk, create savings and assure continued coverage for the working poor,” he said.

Hutchinson also wants to see changes to the tax-credit subsidies in the bill, saying they need to make health coverage affordable for low-income people.

Hutchinson’s proposed changes come as the state is seeking federal approval to impose new limits on the hybrid expansion, including imposing a work requirement on some participants. The state is also seeking approval to lower the eligibility cap for the program, which would move 60,000 people off Medicaid.

Republican Sens. Tom Cotton and John Boozman have talked with Hutchinson about his proposals and are sharing them with Senate leadership, their offices said.

“Senator Boozman and his colleagues are continuing to meet this week to try to overcome their differences and revise the plan,” Boozman spokesman Patrick Creamer said. “There are lots of moving parts at the moment, so he doesn’t want to get ahead of things, but he hopes though that these discussions yield a revised version that can be sent to (the Congressional Budget Office) by the end of the week.”


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

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