Arkansas lawmakers are weighing changes to the state's compromise Medicaid expansion that will test just how much flexibility the federal government is willing to give, according to the head of the Arkansas Senate and an architect of the program.
Senate President Jonathan Dismang said he's not yet begun counting votes to see if there are enough in his chamber to continue the "private option," which uses federal Medicaid funds to purchase private insurance for low-income residents. Dismang has said the program will have to dramatically change in order to survive another year after several candidates who vowed to end the program were elected in November.
"I think you'll see a thorough testing of the boundaries of the private option and also a testing of the willingness of the federal level to continue to provide additional reforms," Dismang said in a recent interview in his office.
Dismang, who was among several GOP lawmakers who crafted the private option, called the program's future a top issue for the Senate in its next session, which begins Jan. 12.
More than 213,000 people are receiving coverage through the program, which was created as an alternative to the Medicaid expansion envisioned under the federal health law. Renewing the program requires a three-fourths vote in the Legislature, and incoming Republican Gov. Asa Hutchinson hasn't said whether he supports keeping it alive.
One possible change, Dismang said, is requiring those on the program to either be working or actively seeking work.
"It's not any of our goal that someone get on the private option and stay there for the rest of their lives," he said. "The goal is they've got some wiggle room to work and improve, get the education they're trying to get and improve their lives for their families."
This wouldn't be the first time lawmakers have altered the program in an effort to keep it alive. The Legislature this year narrowly reauthorized the program after requiring the state to seek changes, including the creation of health savings accounts for some participants.
Dismang also predicted that Hutchinson's top legislative priority — a proposal to cut income taxes for the middle class by $100 million a year — would win widespread support in the Legislature. Dismang said he wanted lawmakers to take up the tax cut bill early on in the session. Dismang and incoming House Speaker Jeremy Gillam, R-Judsonia, are co-sponsoring the legislation for Hutchinson's tax cut plan.
He said he believed the state can afford the loss in revenue, despite warnings from outgoing Democratic Gov. Mike Beebe that lawmakers went too far in tax cuts approved last year.
"We have a $5 billion budget, and what we're looking at is a small fraction of that to cut," he said. "But with growing revenues and a very close look at how we're spending our current dollars, I think it's very possible to achieve that level of tax cut for the people of Arkansas."
Dismang wouldn't rule out other tax cuts making it through the Legislature, but said the focus is primarily on Hutchinson's plan.
"I think the goal is to really try to improve and streamline our tax system here in the state, and that's not accomplished by having 10 different tax cut bills from particular entities or organizations," he said.
Despite corrections officials calling for a new $100 million prison to ease overcrowding, Dismang said it's not a foregone conclusion lawmakers will approve a new facility. He said other options, including using existing unused buildings to house prisoners are on the table. An increase in car tag fees to pay for a new prison is finding little support among lawmakers, he said.
He said, "$100 million is a lot of money and if there's a way to achieve the same results without having to build a new facility, that's what I would prefer to do."