Arkansas at Standstill Over Medicaid Expansion

The state House failed to pass a bill Tuesday that would renew funding for the state’s “private option.”

AURORA, CO - DECEMBER 01: Dental hygienist Denise Lopez cleans the teeth of Ashleigh Britt at a community health center for low-income patients on December 1, 2009 in Aurora, Colorado. 
National Journal
Sophie Novack
Add to Briefcase
See more stories about...
Sophie Novack
Feb. 18, 2014, 11:40 a.m.

Arkan­sas on Tues­day inched closer to a Ted Cruz-style gov­ern­ment shut­down over the state’s plan to ad­opt Obama­care’s Medi­caid ex­pan­sion.

The state House came five votes short of re­new­ing fund­ing for the state’s “private op­tion” plan. The plan is something of a pub­lic-private hy­brid: It takes fed­er­al funds avail­able to ex­pand Medi­caid un­der the Af­ford­able Care Act, but in­stead uses them to pay for private plans on the in­sur­ance ex­change for the newly eli­gible low-in­come in­di­vidu­als.

The House will likely vote on the meas­ure again this week, and Re­pub­lic­an Speak­er Davy Carter has said the House will con­tin­ue to vote on the plan un­til it passes.

The ver­sion be­ing con­sidered is a com­prom­ise on the ori­gin­al com­prom­ise plan. It in­cludes amend­ments that are aimed at dam­aging the private op­tion and the broad­er health care law in the state, without re­vok­ing fund­ing for the over­all plan at this time.

“This is an ap­pro­pri­ations bill that I don’t think any­one in this room really likes, but that most of us can ac­cept,” Rep. Nate Bell said Tues­day on the House floor. Bell — an out­spoken crit­ic of Obama­care and the private op­tion — wrote one of the amend­ments to the ori­gin­al plan, which pro­hib­its state funds from go­ing to out­reach or pro­mo­tion of any part of the health care law.

“I be­lieve it’s im­port­ant as a con­ser­vat­ive that we re­cog­nize the situ­ation we’re in,” he said. “When we can de­feat bad policy, we should do so. When we can’t de­feat bad policy, it’s our re­spons­ib­il­ity to do everything we can to in­flu­ence it and make it as closely aligned with our philo­sophy and policy as we can.”

The private op­tion is be­hold­en to an­nu­al reau­thor­iz­a­tion, as part of the state’s budget for De­part­ment of Hu­man Ser­vices, which runs Medi­caid. Bell warns against reach­ing a budget stand­still, and ar­gues that the Le­gis­lature is at an “im­passe” without enough votes on either side to ap­prove or kill the private op­tion without changes.

Arkan­sas’s high vote threshold for spend­ing bills makes the an­nu­al re­new­al of fund­ing a per­sist­ent chal­lenge: The state re­quires a three-quar­ters ap­prov­al for pas­sage — 75 votes out of 100 in the House and 27 out of 35 in the Sen­ate. Be­cause of the razor-thin mar­gin the first time around, the shift of just a few le­gis­lat­ors in the Sen­ate last month brought the fu­ture of the pro­gram in­to ques­tion ahead of this week’s votes.

The House vote in fa­vor of the ap­pro­pri­ations bill was 70-27 Tues­day, mean­ing no ac­tion was taken.

The ori­gin­al private-op­tion plan ap­peased ex­pan­sion ad­voc­ate Demo­crat­ic Gov. Mike Beebe and the wary Re­pub­lic­an-con­trolled state Le­gis­lature enough to gain nar­row ap­prov­al last year. CMS is­sued the state a waiver in Septem­ber, and Arkansans began en­rolling in the pro­gram in Oc­to­ber, with cov­er­age be­gin­ning Jan. 1.

Thus far 96,950 have en­rolled, ac­cord­ing to the Arkan­sas Medi­caid of­fice. The state es­tim­ates that between 200,000 and 250,000 could be eli­gible for the pro­gram.

Op­pon­ents of Tues­day’s bill largely tie the private op­tion to Obama­care, and ar­gue that spend­ing should not con­tin­ue on a pro­gram that they see as hav­ing an un­stable found­a­tion. Ad­voc­ates ar­gue that the pro­gram will be cost-ef­fect­ive, and that ex­pan­ded cov­er­age is needed in the state, which pre­vi­ously had a high rate of un­in­sured, and an ex­tremely re­strict­ive Medi­caid pro­gram.

Re­vok­ing the private op­tion would leave the nearly 100,000 Arkansans who have en­rolled thus far without health in­sur­ance.

If and when the bill passes the House, it will be sent to the Sen­ate for ap­prov­al. Ac­cord­ing to the As­so­ci­ated Press, Bee­bee and Sen­ate lead­ers be­lieve they have just reached the ne­ces­sary votes to re­new the pro­gram, fol­low­ing ne­go­ti­ations.

What We're Following See More »
TWO MONTHS AFTER REFUSING AT CONVENTION
Cruz to Back Trump
1 days ago
THE LATEST
WHO TO BELIEVE?
Two Polls for Clinton, One for Trump
1 days ago
THE LATEST

With three days until the first debate, the polls are coming fast and furious. The latest round:

  • An Associated Press/Gfk poll of registered voters found very few voters committed, with Clin­ton lead­ing Trump, 37% to 29%, and Gary John­son at 7%.
  • A Mc­Clatchy-Mar­ist poll gave Clin­ton a six-point edge, 45% to 39%, in a four-way bal­lot test. Johnson pulls 10% support, with Jill Stein at 4%.
  • Rasmussen, which has drawn criticism for continually showing Donald Trump doing much better than he does in other polls, is at it again. A new survey gives Trump a five-point lead, 44%-39%.
NO SURPRISE
Trump Eschewing Briefing Materials in Debate Prep
1 days ago
THE DETAILS

In contrast to Hillary Clinton's meticulous debate practice sessions, Donald Trump "is largely shun­ning tra­di­tion­al de­bate pre­par­a­tions, but has been watch­ing video of…Clin­ton’s best and worst de­bate mo­ments, look­ing for her vul­ner­ab­il­it­ies.” Trump “has paid only curs­ory at­ten­tion to brief­ing ma­ter­i­als. He has re­fused to use lecterns in mock de­bate ses­sions des­pite the ur­ging of his ad­visers. He prefers spit­balling ideas with his team rather than hon­ing them in­to crisp, two-minute an­swers.”

Source:
TRUMP NO HABLA ESPANOL
Trump Makes No Outreach to Spanish Speakers
1 days ago
WHY WE CARE

Donald Trump "is on the precipice of becoming the only major-party presidential candidate this century not to reach out to millions of American voters whose dominant, first or just preferred language is Spanish. Trump has not only failed to buy any Spanish-language television or radio ads, he so far has avoided even offering a translation of his website into Spanish, breaking with two decades of bipartisan tradition."

Source:
$1.16 MILLION
Clintons Buy the House Next Door in Chappaqua
2 days ago
WHY WE CARE

Bill and Hillary Clinton have purchased the home next door to their primary residence in tony Chappaqua, New York, for $1.16 million. "By purchasing the new home, the Clinton's now own the entire cul-de-sac at the end of the road in the leafy New York suburb. The purchase makes it easier for the United States Secret Service to protect the former president and possible future commander in chief."

Source:
×