By Steve Brawner
© 2016 by Steve Brawner Communications, Inc.
The question came to mind as Gov. Asa Hutchinson addressed reporters Tuesday: “Governor, when you were a young man fighting to make the Republican Party more than a tiny minority concentrated in the state’s northwest corner, did you ever think it would eventually dominate state politics, and you would lead it, and your most important priority, for a time, would be saving a government health care program?”
The question was not asked. It wasn’t the time or place. Hutchinson makes himself available to reporters and respectfully tries to answer questions. But he’s not a soul-barer.
At issue is Arkansas Works, Hutchinson’s version of the private option. That’s the program created in 2013 after the Supreme Court ruled states under Obamacare could choose whether or not to expand Medicaid coverage to adults with incomes up to 138 percent of the poverty level. Arkansas bucked the trend of other Republican states by accepting the money, but instead of expanding Medicaid, it used it to buy private insurance for that population. As of the end of January, 267,590 Arkansans were eligible.
In the recent special session, Arkansas Works passed 70-30 in the House and 25-10 in the Senate, with support from majorities of Republicans and Democrats in each chamber. But while those votes made it the law of the land, it still must be funded during the Legislature’s current fiscal session. Those majorities fell a little short of the 75 percent needed in each chamber to fund the Department of Human Services’ Medical Services Division, which includes Arkansas Works and other Medicaid programs, including nursing home care.
Opponents, all Republicans, say the private option/Arkansas Works is another health care entitlement for able-bodied adults that neither the state nor an indebted nation can afford. The talk around the Capitol has been whether they will successfully hold up the entire Medical Services Division budget to stop Arkansas Works.
Going into Thursday, the program had enough votes in the House for funding, but none of the 10 Senate opponents had publicly said they were budging. On Thursday, a plan was hatched where legislators would fund Medicaid without Arkansas Works, but Hutchinson would veto just that part of it, and legislators wouldn’t override the veto. But that idea failed, at least temporarily, to advance out of the Joint Budget Committee. So we’re still stuck.
It’s too much to say Hutchinson’s governorship depends on this government health care program, but it is really important to him – important enough that he’s never going to allow 10 senators to stop him. Over the next five years, Arkansas Works is projected to bring $9 billion into the state’s health care economy at the same time the state will lose $5 billion because of other aspects of Obamacare. The state has 19 hospitals that are considered financially vulnerable. Dropping the program would add $1 billion to the amount of uncompensated care they and other providers would provide their uninsured patients.
It also would have a $757 million impact on the state budget, which was one reason why Hutchinson spoke before reporters Tuesday. He wants to call legislators back into special session after this current one to increase funding for highways. The state needs to find about $50 million a year to become eligible for $200 million in federal funding. Hutchinson said that without Medicaid dollars, the state can’t find the matching money for those highway dollars – without raising taxes, which he won’t do.
Like all Republicans, Hutchinson takes pains to declare he opposes Obamacare, even as he depends on Obamacare money. He’s been accused by some of being hypocritical.
He says he’s playing the cards he was dealt. He’d prefer the federal government send those Medicaid dollars to the states as a block grant – still federal government money, by the way – and let the states use that money as they choose without all the strings attached.
Currently, the federal government under President Obama won’t do that. However, you may have noticed we’re in the middle of a presidential election. Maybe the next president will be more open to that idea. That being the case, Arkansas had better stay in the game, Hutchinson says.
That means putting his office on the line, and grappling with members of the party he helped build, so he can save a government health care program that depends on an idea he doesn’t support. Does that make sense? In politics, sometimes yeah.