I have noticed some recent discussion on the vote coming up in the fiscal session next year to continue funding Arkansas’ private option/Medicaid expansion that I think needs to be addressed.
I will use as an example a response from a Republican State Senate candidate in Jonesboro, Dan Sullivan, who said last week that he “will vote against the Private Option if I can be shown how to separate it from DHS’ budget. DHS provides vital services to our most vulnerable people.”
This post is certainly not about Sullivan. His response is reflective of some talk I have been hearing that the vote to continue the funding for the private option will be part of the overall appropriation for the Arkansas Department of Human Services (DHS) and that it will not be possible to separate the two funding issues.
I would like to take you back to the House Public Health Committee in April of this year for an important discussion between Rep. Kim Hammer (R-Benton) and Rep. John Burris (R-Harrison).
Burris is chair of Public Health and was the lead sponsor of the private option legislation in the House. When presenting the bill to the committee, Hammer pressed him hard as to whether House members would be forced to vote against the whole DHS budget if they opposed the Medicaid expansion.
“Just to be straightforward, what I don’t want to see happen is that if some of us or anybody chooses not to go along with the Medicaid expansion, we have to vote your whole budget down,” said Hammer during the discussion. “All of sudden it is going to show up in the paper that we threw grandma back on the street again for the second time this session and other issues. Am I incorrect in that interpretation that that theoretically could happen if we have to vote against your appropriation because we don’t like the expansion?”
“I am not going to put any of you in a corner and say either we vote for expansion or we shut down Medicaid. That’s a very immature argument and it’s not one that I am going to make,” promised Burris. “If 75 people don’t pass it, then we will do what we need to do to take it out and pass the appropriation to fund DHS as it exists today.”
Thinking ahead, Hammer made sure this assurance would apply to fiscal sessions as well.
“Is this a subject that we are going to be able to bring in the fiscal session or would it require a two-thirds vote of the body to bring Medicaid up for discussion during the fiscal session because that will be our next opportunity to talk about it?” asked Hammer.
Burris responded that while it would take a two-thirds vote to bring up substantive legislation such as the mechanics of the private option, an appropriation can be changed with simply a majority of the Joint Budget Committee so the DHS budget can be amended to take out the portion of funding for the private option if it does not have adequate support.
“One of the points I have often made is that we have annual circuit breakers because we are back here voting on this appropriation,” said Burris. “I think (DHS) Director (John) Selig would say that I and others have been incredibly direct with how the legislature has participation and input in it. And I think they are respective to that because we start pre-budget hearings not that long from now. And we have got the ability every year to have input through the appropriation process.”
These “annual circuit breakers” were a key point in getting many on the fence (including myself) on board with supporting the private option. The promises were crystal clear when the private option narrowly passed during the regular session and certainly should still be in place in the fiscal session.
UPDATE: Sen. Jonathan Dismang (R-Beebe), lead Senate sponsor for the Arkansas Private Option, sent me this note Monday evening.
“I have no interest in turning the DHS budget into an all or nothing political game. If the DHS appropriation cannot attain the needed votes with the private option included, then it will be pulled, amended, and voted separately,” said Dismang.
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