Gov. Asa Hutchinson tries to save expanded Medicaid in Arkansas

Long before the state turned solidly red, Asa Hutchinson was the face of the Republican Party in Arkansas. Born in the arch-conservative hometown of Wal-Mart, the mild-mannered attorney made a bold effort to unseat a Democratic political giant, Sen. Dale Bumpers, and later as a congressman even prosecuted the impeachment case against native son President Bill Clinton.

When he ran for governor in 2014, Hutchinson predictably echoed the party's attacks on President Barack Obama and the Affordable Care Act, which he called for repealing.

But two years after winning office with 55% of the vote, Hutchinson has executed a surprising political turnabout and become the leading rescuer of the one of "Obamacare's" most embattled elements, the expansion of Medicaid.

He's now imploring Republican lawmakers to keep Arkansas' hybrid version of the expanded insurance program for low-income people, which was pushed through by his Democratic predecessor, Mike Beebe, and is warning about the potential impact of ending it for a rural state with limited revenue and many living near the poverty line.

"I did not want to punish Arkansas simply to make a political point," Hutchinson told The Associated Press as the Legislature prepares to return to session next month to take up Medicaid's future.

Hutchinson's position, which has inflamed some in his party, shows the difficulty of juggling the politics and practical aspects of a controversial healthcare law that means billions of dollars in federal money for states. About a third of the states_most controlled by Republicans— have rejected expanding Medicaid, calling it an excessive government overreach. The handful of Republican governors who have backed expansion were mostly more moderate and in states that Obama carried, such as Michigan and Ohio.

But Hutchinson is no moderate. He has led the charge in Arkansas for deep tax cuts and tough anti-abortion legislation. Those watching his temperate stand on the health plan wonder if it foretells a possible softening of opposition in conservative states when more people get coverage.

"It would hurt Arkansas to say we're going to allow Washington to take all this money out of the state," he said, considering it would end "health care coverage for the 200,000 plus that's on that Medicaid expansion."

Arkansas is expected to get more than $1.6 billion in federal funds next year for Medicaid recipients. The federal government covered 100% of the expansion's costs, with its share gradually declining to 90% in 2020. Since the enrollment was expanded in 2013, the proportion of Arkansans without insurance has dropped from 22% to 9.6%.

Hutchinson, 65, makes the case for covering additional people in his typically understated fashion. Lanky and soft-spoken, he sounds more like an attorney calmly persuading a jury in a trial, and he often relies on charts and graphs in his speeches.

Few of his Republican colleagues in the statehouse will criticize him directly, but many are determined to beat him on the issue.

"I think he's trying to have it both ways" on Obamacare, said Republican Rep. Donnie Copeland, who regularly criticized the Medicaid expansion in his last campaign. "That doesn't make him a bad guy. That just makes him wrong."

Republican Senate opponent Bart Hester said he believes there are enough votes in the 35-member Senate to block Hutchinson's plan, which requires three-quarters approval in both the Legislature's GOP-controlled chambers.

"This guy has been fighting for conservative principles since before I was born. He's earned the right to disagree a little bit," Hester said.

Arkansas' hybrid expansion of Medicaid, which passed in 2013, uses federal funds to purchase private insurance for low-income residents. During his gubernatorial campaign, Hutchinson ducked saying what he'd do with the program.

After his election, and after a task force studied the options, Hutchinson called for keeping the expanded coverage with new restrictions such as charging premiums to some recipients.

Many recipients are now waiting in suspense for the Legislature's decision. Lauren Coopwood, a chiropractic assistant from Marion, enrolled about a year ago after Medicaid expanded its rolls. Coopwood, 28, said she doesn't know what she and her husband, a full-time student at the University of Memphis, would do if the program ends.

"Then what?" said Coopwood, a Republican who said she voted for Hutchinson two years ago, adding, "we can't afford another private (plan). We really have just been quiet about it right now and hoping for the best, I guess."

Democrats are gleefully pointing out Hutchinson's problems within his own party.

"I've got to say, I've never seen somebody embrace a program and run away from it at the same time," Senate Minority Leader Keith Ingram, a Democrat from West Memphis, said last month.

Hutchinson's Democratic predecessor said expanded Medicaid makes the most sense financially for Arkansas, even for those who disagree with the Obama health plan as national policy.

"We said the same thing" in 2013, Beebe said. "We said if you want to fight Obamacare, go to Washington."



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