Arkansas Speaker of the House Jeremy Gillam, R-Judsonia, is worried about the additional costs coming with Arkansas Works and stressed that federal waivers to allow the state more flexibility are key.
Last week when new data showed that Arkansas’ Medicaid expansion private option program – soon to become Arkansas Works – enrolled or made eligible more than 300,000 citizens, State Sen. Jim Hendren, R-Gravette, said, “The entire Affordable Care Act is on a trajectory that is unsustainable.”
Gillam, appearing on this week’s Talk Business & Politics, agreed.
“I think the numbers are telling that story,” he said. Gillam hopes that Arkansas Department of Human Services director Cindy Gillespie’s plans to rein in Medicaid costs can curb the looming budget pressure that the state will incur once it starts picking up more of the tab for Medicaid costs.
“I think with the five-year plan she’s working on – both to address Arkansas Works and that population and the Medicaid population as a whole – I think we’re going to be able to see some things over the next year or two come from there that will be able to help us go against this trend in a positive way,” said Gillam.
It is too early in the budget process to make definitive determinations as to the future of the healthcare program, the Speaker said, but he warned that there was a threshold where an inevitable decision may have to be made.
“At some point, this is just math. We have to make our budget work, we have to live within our means,” he said. “My hope is that we’re going to have a collaborative relationship with the federal government on these waivers, so I’m going to withhold any kind of predictions or anything at this point, but they [the feds] need to be cognizant of the math just like we have to be.”
Arkansas is waiting for the federal government to determine if it can have more flexibility in its Medicaid expansion program through federal waivers that partially include:
- Requiring individuals eligible for Medicaid to enroll in employer-sponsored insurance where available, with Medicaid covering employees’ costs that would exceed Medicaid levels and providing benefits not covered by the insurance.
- Implementing work training referral requirements with a continued discussion with President Obama’s administration on specific work requirements.
- Requiring premium payments for beneficiaries with incomes above 100% of the federal poverty level, with a consideration of contributions for those with incomes above 50%.
- Restricting coverage or requiring greater cost sharing by individuals with substantial assets.
- Eliminating the current retroactive eligibility that allows new beneficiaries to be covered for expenses incurred 90 days before they were enrolled.
Speaker Gillam also said he expects to see Republican gains in the Arkansas House of Representatives after the November election. Currently, there are 64 GOP members, 35 Democrats and one Independent.
Gillam side-stepped predicting the final total of Republicans and Democrats.
“I’m looking at it more district-by-district versus the totality at this point. We want [as many] good, solid representatives coming into Little Rock that have a mindset for policy, that are interested in moving the state forward,” he said. “From my perspective where we’re at right now, and looking at the map, I think that will lead to us having more Republicans.”
The Speaker of the House is also one of the few elected officials in Arkansas to disavow support for GOP Presidential nominee Donald Trump. Two weeks ago after the release of the damaging Access Hollywood video with Trump discussing groping women and getting away with it because he’s famous, Gillam went on the record saying, “Although I have not been a supporter of Mr. Trump in the past, I have remained hopeful that he would give me a reason to vote for my party’s nominee. I no longer have that hope. I believe he should withdraw from the race immediately.”
Gillam reiterated his opposition to Trump and Democrat Hillary Clinton, while saying he currently will cast his vote for conservative independent Evan McMullin, who was a guest on TB&P in late August.
“Even since then, with the way that he [Trump] has responded to issues and even through the final debate, I’m just not at a place that I feel comfortable in giving my vote to him,” Gillam said. “Right now, I like what I’m seeing from Mr. McMullin.”
Gillam also said Trump’s assertion that the election is “rigged” is also a misnomer. The Speaker said while human error and small glitches may occur, there is no widespread voter fraud.
“I don’t think so… we’re in good shape in Arkansas.”
Watch a video interview of Speaker Gillam below.