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Arkansas panel rejects senator's plan for Medicaid

Legislative leaders envision session wrapping up soon by Michael R. Wickline | February 22, 2018 at 4:30 a.m.

A legislative panel Wednesday ditched a proposal by Sen. Bryan King, R-Green Forest, aimed at turning Arkansas' version of Medicaid expansion -- under which the state purchases private health insurance for some low-income Arkansans -- into a fee-for-service program.

Meanwhile, the Senate's leaders said they are aiming to wrap up action in this year's fiscal session that started on Feb. 12 by the end of next week. But a House leader said he's not sure that's going to happen.

Wednesday was the 10th day of this fiscal session. The previous four fiscal sessions ranged from 25 days in 2010 to 38 days in 2014.

Legislative leaders said they've not started negotiations with Republican Gov. Asa Hutchinson on the Revenue Stabilization Act, which will distribute general revenue to state agencies for fiscal 2019. Fiscal 2019 starts July 1.

Hutchinson has proposed a $172.8 million increase in the general revenue budget to $5.6 billion in fiscal 2019 and setting aside $64 million as surplus funds with $48 million earmarked for a restricted reserve fund and $16 million to help match federal highway funds.

The Senate and House haven't yet taken action on the Department of Human Services' Medical Services Division's appropriation, which includes spending authority for Arkansas' version of Medicaid expansion called Arkansas Works. The program provides health insurance to about 280,000 low-income Arkansans.

The appropriation is Senate Bill 30, which would grant $8.2 billion in spending authority to the Medical Services Division in fiscal 2019. The department has projected that the Arkansas Works program would cost $135.6 million in state funds and about $1.95 billion in federal funds. The state is required to cover 6 percent of funding this year, 7 percent next year and eventually 10 percent. The federal government covers the rest.

Appropriations require a three-fourths vote for approval in the House and the Senate. That requires 27 votes in the Senate, which has 32 senators and three vacant seats, and 75 votes in the House, which has 99 representatives and one vacant seat.

King proposed amending SB30 to require the Human Services Department to apply for a waiver to obtain federal approval to transfer the population served by Arkansas Works to the traditional Medicaid program.

Under King's amendment, if the department were unable to secure the approvals requested before Jan. 1, 2019, the department would be barred from allocating, budgeting, expending or using appropriations under this bill for the participation of people in Arkansas Works.

The proposal wouldn't prohibit the payment of expenses incurred before Jan. 1, 2019, by people participating in Arkansas Works who were determined to be more effectively covered by the traditional Medicaid program.

"Basically what I am proposing is today is to go away from this high-cost, high-expense, waste, fraud and abuse-riddled big insurance program and move these people to Medicaid," King told the Joint Budget Committee's Special Language Subcommittee. "We would have the same match rate for this population that we would. It would cost less. We would be able to root out waste, fraud and abuse much better than what is going on today.

"This would not kick anybody off coverage. They would still have coverage, and it would do what practically every other state that has expanded Medicaid is doing," King said.

But Rep. Johnny Rye, R-Trumann, said, "I just can't see how you're going to save money doing this. I don't understand."

A motion by Rep. Charlotte Douglas, R-Alma, to add King's amendment to SB30 failed. No subcommittee member seconded Douglas' motion.

Asked about King's proposal, Hutchinson said in a written statement, "everything Senator King proposes is of growing irrelevance."


Sen. Larry Teague, D-Nashville, told the Joint Budget Committee, of which he is co-chairman, that he wants to wrap up the fiscal session by next Thursday.

"We're going to go home next week if we can," he told reporters.

Senate President Pro Tempore Jonathan Dismang, R-Searcy, said he also wants to end the fiscal session by the end of next week.

The committee's other co-chairman, Rep. Lane Jean, R-Magnolia, told reporters, "I think they intend to, but I'm not sure we're going to make it."

Senate Republican leader Jim Hendren of Sulphur Springs said the required 27 votes to approve the Medical Services Division's appropriation aren't locked up at this point.

"It is not locked up until the vote is cast. People are still reluctant to give me a hard answer because there are still negotiations going on, so I am just giving you my gut feeling. ... I don't think people want to hold the session up, hold the budget up [and] be dysfunctional," Hendren said.

"We're hoping to get out Thursday or Friday next week," he said, adding that he told the Senate Republican Caucus that the session is either going to be completed by the end of next week or the end of the following week.

Hendren said "it would be helpful if Washington will give us an answer" on the state's request for a waiver to require many of the Arkansas Works' enrollees to work.

Metro on 02/22/2018

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