Medicaid work rule tops governor debate

The three candidates for governor, Republican Gov. Asa Hutchinson,(from left) Democrat Jared Henderson and Libertarian Mark West, finish their debate Friday at the University of Central Arkansas in Conway.
The three candidates for governor, Republican Gov. Asa Hutchinson,(from left) Democrat Jared Henderson and Libertarian Mark West, finish their debate Friday at the University of Central Arkansas in Conway.

CONWAY -- Republican Gov. Asa Hutchinson and Democratic challenger Jared Henderson disagreed Friday whether scrapping Hutchinson's work requirement for the Medicaid expansion program would kill support for the program in the Legislature.

They also sparred over Henderson's proposed criminal justice overhaul that's aimed at saving money in the long run.

Along with Libertarian candidate Mark West of Batesville, Hutchinson of Rogers and Henderson of Little Rock debated for an hour at the Arkansas Educational Television Network here in their second debate of the campaign. The program was to air Friday night.

Henderson, a former state director of the Teach for America program, said Hutchinson has created a new bureaucracy and a part-time website "to put between some of our citizens and access to health care."

Hutchinson's administration imposed a work requirement on many of the nearly 260,000 people covered by the state's version of Medicaid expansion for low-income Arkansans. Henderson referred to a requirement that participants must log in at a state website to show they are working, going to school or volunteering, or else lose coverage.

"I am all for able-bodied people working and doing their part, but I think that access to health insurance is an enabler of that, not an inhibitor," Henderson said. He said 16,000 people are on track to be dropped from the program and, if that happens, it could put the survival of some rural hospitals at risk, and increase the cost of health insurance to make up for the increased uncompensated care provided by doctors, nurses and other health care professionals.

Gov. Asa Hutchinson (left) shakes hands with Democratic challenger Jared Henderson during a gubernatorial debate Friday in Conway that also included Libertarian candidate Mark West (right). Hutchinson and Henderson sparred over Hutchinson’s Medicaid work requirement and Henderson’s criminal-justice plan.
Gov. Asa Hutchinson (left) shakes hands with Democratic challenger Jared Henderson during a gubernatorial debate Friday in Conway that also included Libertarian candidate Mark West (right). Hutchinson and Henderson sparred over Hutchinson’s Medicaid work requirement and Henderson’s criminal-justice plan.

Hutchinson defended the work requirement that was implemented this summer with the approval of a waiver from President Donald Trump's administration. He suggested that removing the requirement would mean the death of the Medicaid expansion program in the Republican-majority Legislature.

"The people of Arkansas support this kind of work requirement for able-bodied individuals ... and Mr. Henderson's idea would cost us a lot," he said. "First of all, to say that someone who is able-bodied shouldn't have to be working when they don't have dependent children adds to that burden and that generational poverty. We want to move them to work.

"Secondly, under Mr. Henderson's proposal, there would be over 250,000 people that would lose their health insurance ... because without that work requirement, we will not have the support of the Arkansas Legislature and the Arkansas public," Hutchinson said. "They would lose their insurance. The whole program would die. The work requirement is the right balance."

Henderson countered, "I simply don't agree that the majority of the Arkansas public doesn't support helping some of our most vulnerable citizens have access to health care.

"And I think when the governor talks about getting support from the Legislature, he is thinking about Medicaid through the same political lens that he has probably thought about it for 30 years as a big government versus small government problem," he said. "And if we want to spend less on Medicaid, I think all of us up here do, it is not by throwing people off or creating obstacles. It's about solving the underlying problem."

If the state could cut teenage pregnancy by 30 percent to 50 percent in a five- or 10-year period, it would be spending dramatically less on Medicaid and won't leave a single vulnerable citizen behind in the process, Henderson said.

But Hutchinson said, "Mr. Henderson raised the point that somehow that we are going to magically get the Legislature to approve 250,000 being on the expanded Medicaid when we don't have reform measures like the work requirement."

He said a three-fourths vote of the Legislature is required to reauthorize the use of state and federal dollars for the Medicaid expansion in each fiscal year.

"This is where it is not a practical solution to say we are going to do away with the work requirement," the governor said.

Afterward, Henderson said it was "a ridiculous claim" to suggest that doing away with the work requirement would kill the program.

"I don't see why we cannot continue to keep expanded Medicaid without his Internet requirement," he said. "I understand the political realities he is talking about. But if I am elected governor, I am going to go with Republican legislators and we'll go county to county. We'll go in their hospitals. They will hear from their own doctors and patients and citizens how much they depend upon Medicaid. It would be suicide in a lot of our communities to cut it back."

West, who is corporate office manager for Mechanical Construction Services in Newark, said, "The state should not be involved in providing health care to people. What this does is it robs the state of Arkansas because so many of our citizens are people who believe in charity."

Hutchinson said he wants to continue to create jobs, "build a transportation system that is second to none" and improve teacher pay from $31,800 to $36,000 a year. He also wants to reorganize state government in the next four years.

Henderson has proposed raising minimum teacher salary from $31,800 to $48,090 over a 10-year period at total projected cost of about $870 million over that time.

"Mr. Henderson has another plan that says we'll pay for teacher pay increases by letting out 20 percent of our prison population," Hutchinson said. "Let me tell you that if you let thousands and thousands out of prison arbitrarily without a plan, then you are going to wind up increasing the danger to our society. That's not the right way. We got a better plan to pay for the increase in teacher pay," he said, referring to his plan that would ultimately cost $60 million a year.

In response, Henderson said, "I think Gov. Hutchinson just became the first sitting Arkansas governor to say our state is not capable of matching the achievements of Mississippi.

"Gov. Hutchinson just criticized my criminal justice plan that I released last week," Henderson said. "I proposed doing what Mississippi has already done over the last eight years. Over the last eight years, Mississippi has cut their prison population by 18 percent. Crime has dropped down. They already have saved $30 million. They are on track to save a quarter of a billion over the next decade."

Hutchinson said Mississippi has a burgeoning prison population because "they had put in truth-in-sentencing" and "they had enhanced their penalties" and "started implementing the reforms that we have already implemented in Arkansas, so Mr. Henderson's talk about Mississippi is not really not applicable here."

West said the state should release people convicted of drug-related offenses from prison and transition them back into society.

Metro on 10/13/2018

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