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Ax Arkansas' Medicaid expansion, governor hopeful says

by Michael R. Wickline | March 27, 2018 at 4:30 a.m.
Jan Morgan talks to a reporter Monday at a deli near the state Capitol about her position on issues such as Arkansas Works. Morgan is running in the Republican primary against incumbent Gov. Asa Hutchinson.

Arkansas' version of Medicaid expansion, which provides health insurance to about 285,000 low-income Arkansans, is socialized medicine and the state would have been better off without it, Republican gubernatorial candidate Jan Morgan said in an interview Monday.

Morgan, a gun range owner from Hot Springs, also said she is worried that the 18-member Arkansas School Safety Commission, appointed by Republican Gov. Asa Hutchinson, will lead to unfunded mandates on school districts.

Morgan, who is challenging Hutchinson in the May 22 Republican primary, was interviewed for an hour by the Arkansas Democrat-Gazette at the Capitol Bistro just east of the state Capitol. During the interview, the governor dropped by to pick up an order.

He and Morgan acknowledged each other as he left, and she told him, "Hi, governor, look forward to that debate."

But no debate is scheduled.

Hutchinson campaign spokesman Jamie Barker said later that "a debate should not even be considered so long as Mrs. Morgan refuses to support the Republican nominee." A month ago, Morgan said she wouldn't endorse Hutchinson if he won the primary.

Her spokesman, Tracy Horne, countered Barker: "What does not endorsing Asa have to do with having a debate or not?"

The candidates also have different opinions about Arkansas Works.

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Morgan's campaign website states that she opposes Arkansas' version of Medicaid expansion that is now called Arkansas Works.

The website says that "we should end this program now, under our own terms, before this is forced on us by the federal government." Under this program, which is optional to states, low-income Arkansans are covered by private health insurance paid for with Medicaid dollars.

The Medicaid expansion was initially authorized by the Republican-controlled Legislature and then-Gov. Mike Beebe, a Democrat, in 2013. The program is projected by the state Department of Human Services to cost $1.95 billion in federal funds and $135 million in state funds in fiscal 2019, which starts July 1. The state's share of the cost of the program is 6 percent this year, 7 percent next year and then 10 percent starting in 2020 under existing federal law.

The program has created divisions within the state Republican Party that's made it difficult virtually every year since 2013 for supporters to get the required three-fourths vote in the state House of Representatives and Senate for the Medical Services Division appropriation, which includes spending authority for the Medicaid expansion.

Asked how she would end the Medicaid expansion program, Morgan said, "We could have ended it had our legislators not voted to fund it again, and I expected our Republicans to do that.

"They did not. They should have. A number of those guys and gals ran on the promise that they would never expand Medicaid to begin with. ... If [Hutchinson] would have just left our Republican lawmakers alone and let them represent the will of the people who elected them, we wouldn't have had Medicaid expansion. We wouldn't have Arkansas Works," she said.

If elected governor, Morgan said, "What I am going to do is get out of the way of legislators who are representing the people, and the legislators will decide" what to do with the people on Arkansas Works.

"We would have been better off with just Medicaid" for the disabled, senior citizens and the poor, Morgan said.

"I am the candidate that wants to shrink the size of government and get more government out of the lives of the people. I don't support socialized medicine," she said.

Barker, Hutchinson's campaign spokesman, said later that the governor "inherited the private option.

"By working with the Legislature and the Trump administration, conservative reforms like the recently announced work requirement continue to improve the program," he said.

Hutchinson's "efforts to reform the program through Arkansas Works have changed the way Medicaid is administered. There are fewer people on Medicaid today than when the governor took office thanks to a growing economy and the reforms made through Arkansas Works," Barker said.

In the fiscal session that adjourned earlier this month, the Legislature enacted a general revenue budget of nearly $5.63 billion for fiscal 2019, a $172.8 million increase over the current year's funding. The budget also sets aside, at Hutchinson's request, about $64 million as surplus funds.

In February, the governor's office estimated that it would cost an additional $88.6 million a year in state general revenue to eliminate the Arkansas Works program. That is based in part on an estimated 86,500 people in the program signing up instead for the traditional Medicaid program that has a lower federal match than the Medicaid expansion program. The office said the end of Arkansas Works also would mean more uncompensated care costs for hospitals, with the cost to the University of Arkansas for Medical Sciences alone put at $53 million more a year.

Asked about those estimates, Morgan said Monday, "I don't buy that and it is fearmongering by people that are trying to scare people into supporting socialized medicine, and Medicaid in itself is sufficient."

In response, Barker said, "When the private option was adopted under the previous administration, funding for UAMS was cut by tens of millions of dollars.

"If you ended the program, you start by having to restore this funding. We also know that our rural hospitals would suffer loss as well," he said.

"Until Washington changes and replaces the Affordable Care Act, [the governor] will continue to work with the Trump administration to increase the flexibility and reform efforts in the states. Our budget is balanced and we've achieved historic tax cuts, all while having to deal with a flawed health care system as a result of Obamacare," Barker said.

The Patient Protection and Affordable Care Act that produced the Medicaid expansion is sometimes called Obamacare, for former President Barack Obama, who championed it.

Morgan said she is worried the commission that Hutchinson created earlier this month to study school safety will create unfunded mandates for the school districts.

"The last thing we need is Little Rock politicians deciding for our schools in the form of unfunded mandates ... 'Well, you are going to have this many hired police officers,'" she said. "What works for the Little Rock School District might not work for rural Arkansas. Every community is different."

Barker said the governor has full confidence in the school safety commission, that it will research and develop a system of best practices for school safety and protection. The commission is to report to the governor in July and November.

"The goal is not for the commission to tell school districts how to achieve this. It is to provide them additional resources in order to help them make the critical decisions about school safety at the local level," Barker said.

The winner of the Republican primary faces the winner of the Democratic primary -- either Jared Henderson of Little Rock or Leticia Sanders of North Little Rock -- and Libertarian Mark West of Batesville in the Nov. 6 general election. Hutchinson is in his first four-year term.

Photo by Staton Breidenthal
Jan Morgan (seated left) waves to Gov. Asa Hutchinson (right) on Monday as a Democrat-Gazette reporter interviews Morgan at the Capitol Bistro deli not far from the state Capitol. Morgan, a Hot Springs gun range owner, is challenging Hutchinson in the Republican primary.

A Section on 03/27/2018

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