Arkansas moves forward on health overhaul

Associated Press Modified: November 11, 2012 at 1:31 pm •  Published: November 11, 2012
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Republicans have said an expansion may be possible in exchange for reforms to the program, but many GOP lawmakers are all but declaring the issue dead in next year's session.

"Based on the rhetoric that's been used to date, I don't buy what they're selling," said Sen. Jason Rapert, R-Conway.

Department of Human Services Director John Selig said he's looking at options that could be part of a compromise for legislative approval of the expansion, including requiring co-pays for some of the new enrollees. Selig also said the department is exploring whether the federal government has softened its stance on whether states can opt for a more limited expansion of Medicaid. Some Republican lawmakers have floated the possibility of a smaller expansion.

"We are open to really talking about anything that seems to make sense and helps us get to yes on something that's good for the citizens of Arkansas," Selig said.

Under the 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. When it upheld the health care law back in June, the Supreme Court said the federal government could not take away states' existing federal Medicaid dollars if they refused to widen eligibility.

The direction of the discussion on Medicaid expansion could become clearer on Tuesday, when DHS is scheduled to present its proposed budget for next year. Selig said he planned to have an updated number on the program's shortfall, currently projected to be $358 million.

Republicans have pointed to the expected deficit as another reason to oppose the expansion, though DHS has estimated the state would see a net savings if it expanded eligibility. Incoming Senate President Michael Lamoureux, R-Russellville, said last week he'd prefer for the Legislature to address the shortfall before taking up the expansion issue.

"It seems like you need to deal with the matter at hand before you start talking about the way you wish things were," he said. "I'm not saying it has to be one first completely and then the other, but it does need our immediate attention."

Supporters of the expansion say they're not prepared to declare it dead, and hope the arguments in favor of it would outweigh campaign rhetoric surrounding the federal health care law.

"This is one of those cases where I think it's really important for people to recognize there are really good reasons for campaigning one way and sometimes having to govern another," said Sen. Joyce Elliott, D-Little Rock. "This is one of them."

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Andrew DeMillo can be reached at www.twitter.com/ademillo