The U.S. Supreme Court in June upheld the health care law, but justices said the federal government could not take away states' existing federal Medicaid dollars if states refused to widen eligibility. Under the healthcare law, the federal government agreed to pay the full tab for the Medicaid expansion when it begins in 2014. After three years, states must pay a gradually increasing share that tops out at 10 percent of the cost. Human Services officials said the net cost to the state would reach about $4 million in 2021.
Beebe said he first wanted answers from the federal government on how much flexibility Arkansas would have and whether the state would be locked in to the expansion even if it faces financial problems later. The state Department of Human Services has said expanding Medicaid's eligibility would add 250,000 Arkansas residents to the program.
The federal Centers for Medicare and Medicaid Services told Beebe in an Aug. 31 letter that states that opt for the expansion could later choose to drop the coverage.
"I wanted to make sure we were the masters of our own fate," Beebe said.
The department has said that the expansion would save the state $372 million over the next several years. The agency's estimates factor in savings that they say would result from the federal health care law.
Beebe faces resistance to the expansion from Republicans, who are trying to win control of the state Legislature for the first time since Reconstruction. GOP leaders have expressed skepticism about the state's estimates on savings from the Medicaid growth.