Medicaid expansion bill fails in House for second straight day

Arkansas lawmakers considered a variety of bills on Wednesday (April 14), but the main drama centered on the state’s Medicaid program. For the second day in a row, House members could not muster enough votes to approve a Department of Human Services budget that includes funding for a revamped Medicaid expansion program.

SB 55 outlines the spending for the state’s DHS Division of Medical Services budget, which includes Medicaid expansion under the Affordable Care Act. In 2013, Arkansas first adopted a Medicaid expansion program through the ACA, known as the private option. It struggled nearly every session to reach the three-fourths vote needed for passage as Republican opposition to the ACA hardened.

Under Gov. Asa Hutchinson’s oversight, the expansion program was reworked to include a work requirement and the program was renamed Arkansas Works. A lawsuit struck down the work requirement, but it has often barely cleared the 75% threshold needed for budget bills.

The latest version of Medicaid expansion is called ARHOME (pronounced “Are-Home”), which stands for Arkansas Health & Opportunity for Me.

ARHOME retains the private insurance model for purchasing health plans for participants like the private option and Arkansas Works did. The federal government will cover about 90% of the funding, while the state pays for the remaining 10%. Under current scenarios, on average, the state is responsible for about $200 million per year – $1.032 billion over five-years – for Arkansas Works premium supplements. Unlike Arkansas Works, there is no work requirement, but there are incentives to work.

In Wednesday’s House session, an effort to extract the expansion funding out of the larger DHS budget failed on a voice vote. When the budget measure was presented for a full vote, it received 66 votes, nine short of passage.

PASS & FAIL
In other House action, legislators failed to pass a bill to repeal the soft drink tax, which partially funds the state’s traditional Medicaid program. HB 1546 would phase out the 29-year old tax over a three-year period if revenue growth hit certain thresholds. While 61 members voted for the repeal and 27 voted against repeal, the measure needed 67 votes to move on.

Another tax measure had an easier time. HB 1157 increases the amount of the income tax deduction for a teacher’s classroom investment expenses from $250 to $500 per individual teacher taxpayer. It passed 98-0.

HB 1547 would prohibit a state or local government from mandating vaccines for employees. It does not apply to private businesses. The bill passed the full House on a 78-1 vote.

The Senate failed to pass HB 1426, the Fair Food Delivery Act, which would require contracts between restaurants and food delivery services, like UberEats or Bite Squad. Some restaurants have complained that their reputations suffer from untimely delivery of food or the publishing of outdated menus.

Senators felt the bill was too far-reaching and defeated it with only 6 supportive votes. The vote was expunged meaning it could come back for consideration.

The state Senate also passed HB 1803, the Balloting Integrity Act, which gives new powers to the State Board of Election Commissioners to investigate different aspects of potential voter or election fraud. It passed 33-1.