Republican opponents of Arkansas' hybrid Medicaid expansion blocked funding for the program Thursday, leaving lawmakers scrambling to find a way to save the expanded coverage for thousands of poor people and resolve a standoff over the state's budget.
The Senate voted 25-10 in favor of the Medicaid budget bill, two votes short of the number needed to fund the program, which uses federal funds to purchase private insurance for the poor. An alternate plan aimed at allowing the governor to reinstate the program if it's removed from the Medicaid budget also stalled before a legislative panel.
The votes leave in flux the state's entire Medicaid program, and it comes less than a week after lawmakers approved Republican Gov. Asa Hutchinson's plan to keep and rework the hybrid expansion. The Legislature recessed until Tuesday, and legislative leaders said they hoped to use the long weekend to find a way forward.
Hutchinson said Friday that a plan aimed at allowing him to reinstate Arkansas' hybrid Medicaid expansion if it's defunded is the best chance lawmakers have at quickly resolving a budget standoff over the program.
Hutchinson defended the plan to add a provision to Medicaid's budget that would defund the expansion, which uses federal funds to purchase private insurance for the poor. Hutchinson has said he'll veto that provision if the bill is approved by the Legislature, which would then allow the Legislature to effectively fund the program with a simple majority by upholding his veto.
"We can't fail to provide the services to people in desperate need of medical services," said Senate Majority Leader Jim Hendren, a Republican from Gravette. "So people can threaten and bluff and hold up budgets all they want, but at the end of the day we have an obligation to pass a budget."
After the funding vote failed, the Joint Budget Committee deadlocked on an unusual parliamentary maneuver that attempted to get around Republican opposition and a constitutional requirement that most budget bills need three-fourths approval. It would have added to the budget a provision that would eliminate funding for the hybrid expansion. If lawmakers approve the modified funding bill, it would allow Hutchinson to veto the provision using his authority to reject parts of budget legislation.
This would allow lawmakers to effectively fund the expansion by upholding the governor's veto, which requires a simple majority. A spokesman for Hutchinson said the governor would veto any Medicaid budget provision that defunds the hybrid expansion.
Hutchinson said that there is growing bipartisan recognition that the Medicaid budget must be fully funded.
"That is the responsibility of government and must be done. I'll continue to work with both Democrats and Republicans to achieve a successful resolution," he said in a statement.
More than 250,000 people are on the program, created three years ago as an alternative to expanding Medicaid under the federal health law. The hybrid expansion has unanimous support from Democrats, but has sharply divided Republicans who control both chambers of the Legislature.
Any funding measure approved by the Senate would have to go the House before reaching Hutchinson's desk. House leaders say they're confident they've got more than the 75 votes needed to approve a Medicaid budget with the expansion funded.
At least two of the 10 Senate Republicans opposed to the expansion said they'd vote for the Medicaid budget with the defunding provision, even if it opens the door for Hutchinson to reinstate the program.
But Republican Sen. Alan Clark, who opposes expanded coverage, called the move an attempt to circumvent the state's budget process.
"What we're doing is we're turning the power of the Legislature over to the executive branch," Clark said. "It's the same thing we complain about in Washington all the time."
The plan also faced opposition from Democrats, who said they're wary of stripping out funding for a program they're fighting to save.
"The people I represent are not going to understand that voting against it is voting for it," Democratic Sen. Linda Chesterfield.
House Democrats followed through on their vow to not vote on any budget bills until the impasse is resolved. A measure funding expenses for judges and lawmakers stalled before the House, with most Democrats voting "present" or not voting.
"Until we know where we're going to go with the Medicaid services portion of this budget, everything else is in limbo," House Minority Leader Michael John Gray, a Democrat from Augusta, said.