House Speaker Davy Carter (R-Cabot) says fellow legislators are seeking answers on federal Medicaid flexibility from Gov. Mike Beebe’s Friday afternoon meeting with U.S. Health and Human Services Secretary Kathleen Sebelius.

Talking to reporters following Thursday’s House action, Carter said that there are specific questions he and his colleagues are hoping to resolve in order to determine how the state’s Medicaid budget could be impacted.

“We’re trying to gather this information to make the best decision for Arkansas that we can,” said Carter.

Key questions include:

  • How accurate are the assumptions for expansion, particularly the estimated 200,000 Arkansans who could join the program under expansion?
  • What options are available to the state for the population of potential Medicaid eligibles in the 100%-138% range of the federal poverty level?
  • Can some Medicaid eligible citizens be moved into the health care exchanges? If so, how far can the state go with that track?
  • If another state, such as Ohio or Florida, gets a better degree of flexibility from the feds, can Arkansas also shift into a similar arrangement?

Carter said that even if these questions are answered in a satisfactory manner and the state is able to take a 100% paid-for deal for the next few years, the state’s Medicaid program is “unsustainable” in the long-run.

“It seems to make some sense for a little while, but long-term I don’t think Arkansas can do it long-term,” Carter said, claiming the numbers just won’t work.

He cited concerns about the accuracy of the number for how many citizens may be eligible for Medicaid under expansion. Currently, the estimate is that around 200,000 people out of 1.4 million statewide in the 19-64 age population could be added, but any variance in those numbers could dramatically impact budget projections.

“Let’s say that’s 300,000. That’s a 30% increase. We’re talking about a billion dollars a year coming through here. That’s a lot of money if it’s off just a hundred thousand people,” Carter said.

Beebe will be attending the winter National Governors Association conference in Washington, D.C. this weekend. His meeting with Sebelius may provide answers to those specific questions, it could require further study, or Beebe may be told that the state can present a plan for the fed’s consideration.

On Wednesday, Joint Budget Co-chair Sen. Larry Teague (D-Nashville) told Talk Business that the Beebe-Sebelius meeting is paramount to solving the Medicaid budget debate.

“It’ll be hard for me to be against it [expansion] because I understand that if we lose our rural hospitals we’ve brought our last job to rural Arkansas, our last corporate job,” Teague said. “I think until we know whether we’re going to get some help out of the expansion, I just think we’re hung up there.”

A recently-released Talk Business-Hendrix College poll showed growing support for Medicaid expansion. About 53.5% said they favored expanding the low-income health care program, while 40% were opposed and 7.5% were undecided. Last July, only 42.5% supported expansion, while 46.5% opposed it.

UPDATE:  Gov. Mike Beebe provided a statement to the media on Friday afternoon about his meeting with Secretary Sebelius.

“I had a productive meeting Friday afternoon with Secretary Sebelius. I presented her with the ideas raised by our legislators, particularly the option that at least some of the potential Arkansas expansion population would be able to obtain private insurance coverage through our exchange. The Secretary has given me feedback, which I will share with legislators, concerning the choices available to Arkansans as our state moves forward. I am always cautious in my optimism, but I feel good about Arkansas’s options coming out of this meeting,” Beebe said.

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Roby Brock
Roby Brock is the Editor-in-Chief and Host of Talk Business & Politics. He can be reached by e-mail at Roby@TalkBusiness.net. Follow him on Twitter: @RobyBrock.