The appropriations bill for funding Arkansas Works and other Medicaid programs passed the Legislature’s Joint Budget Committee Wednesday (April 13) and now moves into consideration by the full Senate Thursday.
That $8.4 billion annual appropriation bill, SB121, would fund the Department of Human Services’ Medical Services Division.
Included in that division is Arkansas Works, Hutchinson’s version of the private option, which is the government program that uses federal Medicaid dollars to purchase private health insurance for adults with incomes up to 138% of the federal poverty level. Created in 2013, the private option expires at the end of this year. As of the end of January, 267,590 Arkansans were eligible for coverage.
Members of the Joint Budget Committee passed SB121 on a voice vote Wednesday after a lengthy debate about a provision in the bill some thought could have opened the door to a managed care model. In that model, a private company would manage part of the Medicaid program on a per beneficiary fee basis. Once an amendment by Sen. Missy Irvin, R-Mountain View, failed, the bill passed quickly.
Legislators passed the policy by large margins in a special session last week but fell short of the three-fourths majority in both Houses that will be needed for funding. At least nine of the 10 senators who voted against Arkansas Works have said they will vote against funding the division. That would be enough to block funding. The division includes other Medicaid services such as nursing homes and medical care for foster children.
Hutchinson said in a press availability Wednesday that he believes enough members of the House of the Representatives will vote for the measure to eclipse the three-fourths requirement. He said Speaker Jeremy Gillam, R-Judsonia, had confirmed enough votes have been secured. Gillam said afterwards in an email, “Based on what the members have told me, that is correct.”
Meanwhile, the House Democratic Caucus wants Gillam to focus first on SB121 before addressing any other spending issues. In a letter dated Wednesday, Rep. Michael John Gray, D-Augusta, the House minority leader, wrote that the failure to pass SB121 would create a shortfall and significantly change the budget. Hutchinson said the request is understandable and that SB121 will be considered first.
However, Gray indicated in an interview that House Democrats are considering not even voting on other appropriation bills before SB121 is settled.
“Our intent is clear that we have no intention of voting on anything before Arkansas Works, or for the Division of Medical Services. … In conversations with leadership, we’ve let them know that the caucus is firm and this is where we want to be,” Gray said.
He added, “Obviously, the first bill up in the House tomorrow will be the general appropriation, so I think we’re prepared to set that aside for now.”
Gray said Democrats are considering not voting rather than voting no on the other appropriation bills, which would be enough to deny passage. He said that would be a “game-time decision.”
Hutchinson said he was continuing to work with the 10 senators opposed to Arkansas Works. Speaking to reporters Wednesday, he singled out two: Sen. Linda Collins-Smith, R-Pocahontas, and Sen. Bryan King, R-Green Forest. Under an alternative budget released by the House leadership Monday, Collins-Smith’s district would lose more than $651,000, he said.
“My question to Sen. Smith is, very clearly, ‘Do you support these cuts to your district?’” he said. “If you do not support these cuts to your district, what is your alternative budget, and where do you think those cuts should come from?”
Collins-Smith was not available for comment.
Hutchinson also pointed to comments published in the Madison County Record, where King said he had hoped to see increases in Department of Human Services funding. He said King has indicated it would be easy to cut DHS funding.
“My question to Sen. King is, ‘Do you want us to follow his admonition to the district and increase funding for foster care, or do you want us to listen to his message here in Little Rock that it’s easy to cut – no problem cutting DHS?’” Hutchinson said.
King responded by saying he was referring to spending more money in certain areas, such as foster children, but he supported spending less on the DHS budget overall and is opposed to Arkansas Works, which serves mostly able-bodied adults. He said Hutchinson can’t paint him as a big spender.
“He might as well try to defend O.J., that he’s not guilty, if he’s going to try to go that route,” he said.
Meanwhile, opponents of Arkansas Works in the House and Senate introduced identical resolutions in the House and Senate that would end Arkansas Works and would end the private option by Dec. 31, 2016. The bills by Sen. Bart Hester, R-Cave Springs, and Rep. Bob Ballinger, R-Hindsville, would require a two-thirds vote to be considered.