LITTLE ROCK — Arkansas political leaders Tuesday said they’ll keep working to cut a deal on Medicaid, one day after the Obama administration said it won’t give extra money to states that block full Medicaid expansion.
INTERACTIVE
Incoming House Speaker Davy Carter, a Cabot Republican, said that at least the contours of the negotiations have been brought into sharper focus.
“I’m disappointed that we’re not going to have any flexibility. But at least we know what we’re dealing with,” Carter said.
Democrats said the announcement wouldn’t stall talks.
“It takes an option off the table, but we still have time,” said Matt DeCample, Gov. Mike Beebe’s spokesman. “We’ll work with what we got.”
Late Monday, the U.S. Department of Health and Human Services announced that states interested in expanding their Medicaid rolls less than 138 percent of the poverty line — the threshold envisioned by the Affordable Care Act — wouldn’t receive the more generous federal funding available to states that cover people at that level and above. The federal government has promised to cover the entire cost of expansion until 2017. By 2020, the states’ share would rise to 10 percent.
The state’s Department of Human Services has estimated that up to 250,000 Arkansans would be added to the state’s $5 billion Medicaid program, which already covers about 780,000 people.
If states want to pursue a more limited expansion of their rolls, they would have to do so on under the current Medicaid funding formula. In Arkansas, the state pays about 30 cents on every Medicaid dollar with the federal government paying the rest, according to the federal announcement.
“Financially, that’s not something we can do,” said Amy Webb, Department of Human Services spokesman, referring to expanding the program under current funding.
Republican leaders had said for months that they might be willing to agree to a smaller expansion as part of a deal. With that avenue closed, GOP leaders pledged to continue to negotiate with Beebe.
“I’m discouraged that [the federal government] is not willing to have serious negotiations. But I want to focus my efforts on working with the governor to craft an Arkansas solution,” said Sen. Michael Lamoureux, a Russellville Republican.
Rep. Greg Leding, D-Fayetteville and an expansion supporter who will be on the House Public Health, Welfare and Labor Committee, said he is confident a deal can still be brokered.
“I don’t think this changes much. I think we can still make this happen,” he said.
Ray Hanley, a state Medicaid director for three governors and current president and CEO of the Arkansas Foundation for Medical Care, said the federal government’s decision was “pretty hardnosed.”
“It doesn’t allow the flexibility that some states and governors should be given — 138 percent of poverty just makes no sense. It’s one size fit all and paints every state with the same rigid brush,” Hanley said.
Someone with an income of $15,400 in Arkansas doesn’t face the same economic challenges as someone with the same income in New York or California, he said.
Politically, ruling out partial expansion in states where President Barack Obama’s health-care law is unpopular is “counterproductive” and complicates the efforts of Beebe, Hanley said.
Carter said that he hasn’t had time to talk to enough members of his party to determine how the federal decision has been received. But he said there is plenty of time to examine the issue.
“I don’t want to get into this time pressure deal,” he said.
Carter and Lamoureux said they were interested in the fate of the global waiver that the state has asked the federal Department of Health and Human Services to approve. The waiver would allow the state to receive more federal money initially — which could help solve the state’s $138 million Medicaid deficit — and might allow for copayments and other Republican-supported measures.
State Department of Human Services officials have said a federal answer on Arkansas’ waiver application isn’t likely before January. But the federal health agency said Monday it would “work with” states that want such waivers and pursue expansion.
“That is definitely one of the better options for Arkansas. If we could effectively get the global waiver and implement some of what we want to do, then maybe we can get a chance at some kind of agreement,” Lamoureux said.
Carter said he eagerly awaits an answer on the global waiver to “see what kind of flexibility we have or don’t have.”
“I don’t have the answers right now. I’m doing more listening than anything,” Carter said.
Front Section, Pages 1 on 12/12/2012