LITTLE ROCK, Ark. (AP) — Arkansas legislative leaders said Thursday that they need more information about the flexibility the state will have if it expands Medicaid and better figures on how much of a shortfall the program faces.
Senate President Michael Lamoureux said lawmakers want answers on whether the state could opt for a smaller expansion than the federal health care law calls for, despite the Obama administration telling states that partial expansion wasn't possible.
"It's more important that we get things right than do it quick. We're literally talking about shaping health care policy for 10 or 20 years. It's not a McDonald's drive-thru," said Lamoureux, R-Russellville. "It's something we need to take our time and be real patient about."
The federal health care law calls for the federal government 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. The U.S. Supreme Court in June upheld most of the health care law, but justices said the federal government could not take away states' existing federal Medicaid dollars if they refused to expand.
Lamoureux also said lawmakers want a firmer number on the shortfall Medicaid will face in next year's budget.
John Selig, the director of the Department of Human Services, said that by a "very rough estimate" savings from the Medicaid program in the current fiscal year could amount to about $50 million. Selig said the program grew at a slower rate than officials had expected and the department plans to release its revised estimate on how much of a shortfall the program will face next year.
Officials had originally projected a $138 million deficit they would have to cover next year by cutting some services, but Gov. Mike Beebe announced earlier this week that the state would avoid the "most painful cuts," including a proposal to remove thousands from nursing home care.
Rep. John Burris, R-Harrison, who chairs the House Public Health Committee, said that a lower-than-expected shortfall makes the challenge of resolving the Medicaid shortfall significantly "more manageable."
He said it's possible that lawmakers would use the state's projected $300 million surplus to cover the entire Medicaid shortfall. Beebe's budget already calls for using nearly half of the surplus to help the program. But he added there is also strong interest in making reforms to make the program more efficient.
"There's a lot more we can do to make the system more efficient," he said Tuesday, without citing specific changes he'd like to make. "We'll be having that debate in the coming weeks."
Selig told members of the House panel Thursday that while there was always room for improvement, the state's Medicaid program is already "very lean" compared with other states.
Beebe, a Democrat, said he believed there was enough time during the session to answer lawmakers' questions about the proposed expansion. He urged lawmakers to back the expanded eligibility in his State of the State address earlier this week.
"You've got to answer tons of questions," Beebe told reporters. "People have got to have the ability to ask and answer every question they want asked and answered before you start messing with anything else."
Republicans have generally opposed expansion, but Lamoureux and other GOP leaders have left open the possibility of a compromise that would allow some form of it in exchange for changes to the program that they believe would save money.
The Arkansas House and Senate recessed on Thursday for a four-day weekend to mark the Martin Luther King Jr. holiday, and planned to return to the Capitol Tuesday.