Arkansas legislators can support continued funding for Arkansas' expanded Medicaid program and still oppose the 2010 Patient Protection and Affordable Care Act, commonly known as Obamacare, Gov. Asa Hutchinson said Tuesday.
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Flanked by about two dozen legislators, including some facing criticism from primary-election challengers over their support for the state's expanded Medicaid program, Hutchinson said at a news conference at the state Capitol that he wanted to "debunk" arguments that those who support the Medicaid program are also supporting the federal health care law.
"I hope that Washington replaces Obamacare, but until then, we would only be punishing Arkansas to turn down federal money that 30-plus states are accepting," Hutchinson said, referring to other states that also have expanded Medicaid, as authorized under the Affordable Care Act.
"It is perfectly consistent, it is perfectly conservative and logical to oppose Obamacare as a federal policy and yet to accept federal dollars under the Medicaid program in Arkansas," Hutchinson said. "It is a logical position. It is an Arkansas-oriented position, and it does not embrace the federal policy that is the framework of Obamacare."
Hutchinson spoke a day before he is expected to update a legislative task force on his proposal to overhaul the expanded Medicaid program, which provides health coverage to about 250,000 low-income Arkansas adults. He plans to rename the program Arkansas Works.
Lawmakers are to vote on changes to the program in a special session that Hutchinson has said he plans to call in early April.
Continued funding for the program will require approval by a three-fourths majority of the Legislature during the fiscal legislative session that starts April 13.
Brenda Vassaur Taylor, an officer with the political action committee Commerce in Action, which has contributed to challengers in the primary election, said Hutchinson is attempting to redefine the Affordable Care Act.
Hutchinson is saying the expanded Medicaid program is not Obamacare "for one reason: because if they admit it is, they won't be re-elected because the people don't want it," she said.
The Affordable Care Act required states to expand Medicaid starting in 2014, but the Supreme Court struck down the requirement in 2012, making the expansion optional.
In 2013, Arkansas became the first state to receive approval to expand its program by using Medicaid funds to buy coverage on the state's federally run insurance exchange under a program that became known as the private option.
Hutchinson, who took office last year, has said he wants to continue providing coverage for the eligible Arkansans, while adding changes to encourage those people to stay employed and take responsibility for their health care.
The federal government is paying the full cost of coverage for the newly eligible enrollees -- about $1.5 billion annually -- through the end of this year. After that, Arkansas will begin paying 5 percent of the cost.
The state's share of the cost will then rise every year until it reaches 10 percent in 2020.
Hutchinson said he opposed the Affordable Care Act because of its requirements for all Americans to have health insurance or pay penalties, and for many businesses to provide coverage to their employees.
While some opponents hoped that the law would "collapse," that didn't happen, and states must deal with "the real world," Hutchinson said.
Ending the expanded Medicaid program, he said, would unfairly leave poor Arkansans without assistance, while those with higher incomes would remain eligible for federal tax-credit subsidies to help them buy coverage.
The tax-credit subsidies are available to many people who don't qualify for Medicaid and who have incomes of 100 percent to 400 percent of the poverty level: up to $47,080 for an individual, for instance, or $97,000 for a family of four.
The private option covers adults with incomes of up to 138 percent of the poverty level: $16,243 for an individual, for example, or $33,465 for a family of four.
Only about 20 percent of those covered under the state's expanded Medicaid program would become eligible for subsidized coverage on the exchange if the state reversed the expansion. The rest would be ineligible for the subsidies because their incomes are below the poverty level.
"It makes no sense to punish those that are in the lower income and continue to subsidize those in the middle income or the higher income," Hutchinson said.
The expanded coverage will help improve the health of the state's residents, he said.
Reversing the expansion would leave a funding gap of more than $100 million in the state's budget, he said.
Hutchinson spokesman J.R. Davis said that $100 million includes the cost of restoring Medicaid programs that were replaced by the private option, providing medical care to the uninsured and the loss of premium tax revenue from private-option insurance plans.
Davis added that, even without Medicaid expansion, the Affordable Care Act would cost Arkansas more than $1 billion annually though cuts in Medicare reimbursement, and taxes and fees on health insurance and medical care.
"We should not be asked to turn down federal money because we want to make a political point, and that is all that would be," Hutchinson said at the news conference.
If a Republican is elected president this year, Arkansas likely will be able to make further changes in how it provides Medicaid coverage, he added.
Senate candidates in the March 1 Republican primary who have vowed to oppose funding for the expanded Medicaid program include state Rep. Donnie Copeland, who is challenging Sen. Jane English in District 34; Lonoke County Justice of the Peace R.D. Hopper, who is challenging Sen. Eddie Joe Williams in District 29; and Washington County Justice of the Peace Sharon Lloyd, who is competing against Rep. Lance Eads in District 7 for a seat being vacated by Sen. Jon Woods.
Vassaur Taylor said her group opposes Medicaid expansion because "it grows government, it grows dependency on government, and it spends money we don't have."
David Ray, director of the advocacy group Americans for Prosperity Arkansas, said in a statement that Medicaid expansion is "one of the core pillars of Obamacare."
"Arkansas legislators should reject any attempts to cement Arkansas' status as an Obamacare Medicaid expansion state," Ray said.
Arkansas House Minority Leader Michael John Gray, D-Augusta, said in a statement that Hutchinson "made it clear he was taking the lead on health policy in Arkansas."
"House Democrats look forward to working with Gov. Hutchinson to protect the future of Arkansas," Gray said. "We know that the people of Arkansas deserve leaders who will put politics aside and look for common sense solutions."
A Section on 02/17/2016