Medicaid funding gains House's OK

Appropriation approved on fifth try as lawmakers aim to recess next week

FILE - In this April 10, 2019 file photo, Arkansas Gov. Asa Hutchinson speaks to reporters in his office at the state Capitol in Little Rock. (AP Photo/Andrew DeMillo, File)
FILE - In this April 10, 2019 file photo, Arkansas Gov. Asa Hutchinson speaks to reporters in his office at the state Capitol in Little Rock. (AP Photo/Andrew DeMillo, File)

The appropriation for the state Division of Medical Services -- which includes the Medicaid program -- passed on its fifth try Tuesday in the House, and with that bill out of the way, lawmakers received copies in the evening of the legislation that sets spending priorities in the next fiscal year.

Tuesday marked the 100th day of the 93rd General Assembly. Legislative leaders, who originally set April 30 as the deadline to recess the regular session, are now aiming to get out by next Tuesday.

The Arkansas House of Representatives approved Senate Bill 55 to grant $9 billion in spending authority of state and federal funds for the Division of Medical Services in the next fiscal year, which starts July 1.

The House voted 78-15 to send SB55 to Gov. Asa Hutchinson, resulting in scattered cheers from representatives on the House floor.

[RELATED: See complete Democrat-Gazette coverage of the Arkansas Legislature at arkansasonline.com/legislature]

The bill required 75 votes for approval in the 100-member House, and it fell short of that mark four times over the previous week.

The House also voted to approve a bill that would implement Hutchinson's plan to reduce the tax on the sale of used vehicles and trailers priced between $4,000 to $10,000. That measure is House Bill 1912 by Rep. John Payton, R-Wilburn. It goes to the Senate for further action. Competition between bills to change the sales tax on used vehicles had affected the vote on the Medical Services appropriation.

The state Division of Medical Services' appropriation since 2013 typically has had difficulty obtaining the required three-fourths vote because it includes spending authority for the Medicaid expansion program that provides private insurance for poor people.

SB55 includes spending authority for both traditional Medicaid and the Medicaid expansion, which together provide health care services to more than 1 million low-income Arkansans, according to the state Department of Human Services.

The Medicaid expansion program was overhauled by lawmakers earlier this session to allow the Human Services Department to seek a new waiver from the federal government to promote work through access to government-subsidized private insurance plans. Enrollees who fail to meet the incentives would be moved to traditional Medicaid under the new plan, called Arkansas Health and Opportunity for Me (ARHOME).

Opponents of the Medicaid expansion attempted to scrap the plan and move all of the enrollees to traditional Medicaid's fee-for-service plan, but that attempt failed.

Rep. Lane Jean, R-Magnolia, co-chairman of the Joint Budget Committee, said before Tuesday's vote that legislative leaders anticipated that the session would end next Tuesday, but that was contingent on the chamber's approval of SB55.

House Speaker Matthew Shepherd, R-El Dorado, and Senate President Pro Tempore Jimmy Hickey, R-Texarkana, filed a resolution last month that would allow lawmakers to meet until April 30 before breaking for an extended recess.

"I've got some good news for you. We're planning on being out of here Tuesday. But we've got some appropriations to get out of here," Jean said.

Rep. Josh Miller, R-Heber Springs, asked Jean if SB55 had "gotten any better."

Miller has been a foe of the state's reworked private option Medicaid-expansion program, the Arkansas Health and Opportunity for Me Act, which was enacted earlier this month. He has argued that the private option makes it harder for elderly and disabled people to access care because fewer doctors and specialists are taking traditional Medicaid patients.

"It's the same bill that y'all voted down four times in a row," Jean said.

Rep. Jim Wooten, R-Beebe, urged the House to vote for the appropriation and bring the session to a close.

"Colleagues, you can wear out your visit. It's time to go home," Wooten said. "If we don't approve this this time, we're going to delay and delay, and folks are telling me they want us to go home. ... We're taking care of the folks of Arkansas. Whether or not you agree with the amount of money, we need to deal with this."

On Monday, the bill fell short of the necessary three-fourths majority by three votes. It garnered 54 yes votes the first time it failed on April 13.

Two competing measures to cut sales taxes on used cars played a factor in slowing down the passage of the SB55.

The House on Tuesday voted 92-0 to send to the Senate HB1912, which would implement the governor's plan to reduce the sales tax on used vehicles and trailers priced between $4,000 and $10,000 from 6.5% to 3.5%.

HB1912 is projected by the state Department of Finance and Administration to reduce state sales tax revenue by $6.5 million in fiscal 2022, which begins July 1, and $13.1 million in fiscal 2023. The bill would become effective Jan. 1.

Hickey had told senators that if the House approved the Medicaid appropriation on Tuesday, "we will try to bring [the Revenue Stabilization Act] on the budget table tomorrow and pass it out Thursday" through the Joint Budget Committee.

"Hopefully, by Tuesday or Wednesday of next week, as long as I work with the House speaker, that ... we'll get out around that time," he told senators.

The proposed Revenue Stabilization Act for fiscal 2022 was placed on lawmakers' desks later Tuesday, after passage of the Medicaid appropriation. The proposal would distribute state general revenue to state-supported programs.

The proposed Revenue Stabilization Act would disburse up to $5.84 billion in general revenue to state-supported programs, up from the state's current budget of $5.68 billion in fiscal 2021.

The proposal would distribute up to $1.37 billion in general revenue to the state's Medicaid program, an increase from the current funded budget of $1.31 billion; up to $762.7 million to the state's colleges and universities, an increase from the current funded budget of $717.4 million; and up to $2.25 billion to the state's public school fund, an increase from the current funded budget of $2.23 billion.

Among other programs, the proposed Revenue Stabilization Act would distribute up to $375 million to the Division of Correction, an increase from the currently funded budget of $360.9 million; up to $96.8 million to the Division of Community Correction, an increase from the currently funded budget of $91.4 million; and up to $70.5 million to the Arkansas State Police, up from $62.3 million.

In another indicator of the lateness in the session, the Senate Committee on State Agencies and Governmental Affairs met late into Tuesday night to work through its agenda. The panel also voted to suspend its rules to consider and advance House Joint Resolution 1005 by Rep. David Ray, R-Maumelle. HJR1005, which was not on the committee's agenda for Tuesday, is a proposed constitutional amendment that would raise the threshold for ballot initiatives to become law to 60% if approved by voters in 2022. The current threshold is a simple majority of votes.

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