Gov. Asa Hutchinson called the debate over Arkansas' hybrid Medicaid expansion a "watershed" moment on Wednesday, as lawmakers advanced his plan to keep and rework the program that provides subsidized health coverage to more than 250,000 people.
The House and Senate are set to take up legislation Thursday outlining the Republican's proposal to keep the hybrid expansion after the plan easily cleared two committees at the start of a special session. The program uses federal funds to purchase private insurance for the poor and was created three years ago as an alternative to expanding Medicaid under the federal health law.
"This is one of those moments in history where your decision will impact our communities, our economy, our balanced budget, our health care system and most importantly the lives of thousands of real people that reside in each of your districts," Hutchinson told lawmakers.
Hutchinson ran for governor two years ago promising to fight President Barack Obama and his policies, including the health overhaul, but ducked saying what he'd do with the state's hybrid expansion that was already covering thousands of people. He's called for adding new restrictions to the program, including charging premiums for some, and warns that ending the expanded coverage would create a budget deficit of at least $100 million.
But he faces opposition from fellow Republicans who control the Legislature, with critics accusing the governor of embracing the health law he's called for repealing. Opponents also said they didn't believe the state or federal government could afford the expanded coverage.
"We are enslaving future generations, our children and grandchildren, to debt that we are irresponsibly paying on their credit card," said Republican Sen. Terry Rice, the vice chairman of the Senate Insurance and Commerce Committee, who voted against the plan.
The panel and its House counterpart endorsed Hutchinson's legislation on voice votes.
GOP supporters of the expansion plan said it would be foolish for the state to give up on federal funds that 30 other states are accepting just to highlight their opposition to the health law.
"We're put in the position where out of some matter of some statement that needs to be made, which we want all want to decrease the federal debt, that we're planning to hurt our local communities when we know that we will not change one aspect of the (federalhealth law)," said Republican Sen. Jason Rapert, the committee's chairman.
Hutchinson acknowledged the divide he faces within his own party over the issue, as well as resistance from some Democrats who say they're wary of any changes that would limit the program.
"Some say these reforms go too far and some say I did not push hard enough for more reform. The criticism from both sides is some indication that we might have it about right," Hutchinson said Wednesday. "It is some indication that we've actually reasoned together and we've come together for a common solution."
Hutchinson also released a letter from U.S. Healthand Human Services Secretary Sylvia Burwell, who said the federal government wanted to work with him on some reforms, such as a requirement that some participants enroll in their employers' insurance if available. She also said that previously floated restrictions, such as an asset test for participants or a requirement that they be employed, aren't allowed by law.
"We appreciate the continuing dialogue regarding the elements of Arkansas Works, and we look forward to continuing to work with you to strengthen the Medicaid program for the state and its residents," she wrote in the letter, dated Tuesday.
Hutchinson's expansion plan requires only a simple majority in this week's session, but the budget bill keeping the program alive will need at least three-fourths support from the House and Senate in a session set to begin next week
