GOP officials float Medicaid special session

Beebe: Should not delay debate over adding 250,000

— Gov. Mike Beebe prefers that lawmakers tackle Medicaid expansion when they convene later this month for the regular session, but Republican leaders said Monday that the idea of a special session devoted to deciding whether to add 250,000 Arkansans to the rolls is appealing.

“I think it’s too early to say definitively, but it is an interesting option,” said Michael Lamoureux, a Russellville Republican and the incoming Senate president. “The goal would be to resolve it during the [regular] session, but, rather than make a bad decision ... it may need to wait.”

Incoming House Speaker Davy Carter, a Cabot Republican, agreed, saying that more information about expansion is still coming from Washington.

“The issue is so important that we don’t need to be rushed,” Carter said, although he said that he would prefer to get it done during the regular session.

Beebe would have to call for a special legislative session. He hasn’t done so since convening lawmakers for a brief special session in early spring 2008 to approve a severance tax on natural gas.

Reports of special-session discussions first surfaced Sunday in a John Brummett column in the Arkansas Democrat-Gazette. Carter said that he hadn’t discussed the idea of a special session with anyone before Brummett’s article and hadn’t previously heard talk about that possibility.

Beebe thinks that the Legislature shouldn’t put off deciding whether Arkansas should enlarge its $5 billion Medicaid program, an option given by the U.S. Supreme Court, said Matt DeCample, Beebe’s spokesman.

And there is the issue of cost, DeCample said. Paying for a special session comes out of taxpayers’ wallets, he said.

The nation’s highest court ruled in June 2012 that states can decide whether they want federal help to enlarge their Medicaid coverage to those making up to 138 percent of poverty.

As the regular session unfolds, the governor will assess the political mood, DeCample said.

“You’ll have to see what happens in the regular session first,” he said. “I don’t know if we’ve ever had a special session talked about before a regular session happens.”

Bob Johnson, former Senate president who served in the House and Senate between 1995-2010, said the old rules might not apply.

Johnson, a Bigelow Democrat, said the “greenhorn” nature at the Capitol - a result of term limits becoming fully implemented in recent years - makes it more difficult for so many newly elected lawmakers to handle “complicated” issues such as Medicaid expansion.

“Pre-term limits, they could handle it more easily,” Johnson said.

This fall, the Beebe administration, spearheaded by state Medicaid Director Andy Allison and Department of Health and Human Services Director John Selig, said expansion was a way to resolve a looming $138 million deficit in the federal-state program that cares for about 780,000 poor Arkansans, including the elderly, the disabled and low-income children. They estimate that expansion would save $159 million during the next two years from more tax revenue and fewer dollars spent on indigent care and some Medicaid recipients.

Republicans, so far, haven’t gone along. Lamoureux said the deficit should be addressed “as if expansion isn’t an issue.” Lawmakers could have time to consider expansion later, he said.

Estimated by the Health Department to result in more than $700 million in savings through 2021, Medicaid expansion has triggered partisan conflict across the country. Many states led by Republicans have said they won’t participate in expansion - which would be funded completely by the federal government until 2017. By 2020, Arkansas would shoulder 10 percent of the costs.

Arkansas Republicans have said they opposed committing state dollars to expansion - in 2018, the state would be responsible for nearly $100 million. They also said that the promised 90 percent in federal funding might fall victim to national deficit paring efforts.

“You wouldn’t buy a house if you didn’t know what it costs,” Lamoureux said.

The Beebe administration contends that the hundreds of millions in projected savings are worth it. Shifting certain Medicaid populations, such as ARKids B and care for pregnant women, either to the more-generous federal match or into the new insurance exchange - set to begin Jan. 1, 2014 - is one source of savings, the agency says.

Allison and Selig have repeatedly stated that if money isn’t found, the state will cut $329 million in services, including Level 3 nursing care, which could affect up to 15,000 mostly elderly patients who need help bathing, walking or using the bathroom.

Some Republicans have characterized that plan as a scare tactic. On Monday, Lamoureux said that Level 3 cuts “aren’t going to happen.”

“We’ll find a solution,” Lamoureux said, citing “onetime money or funds from other agencies,” as a way to avoid Level 3 cuts and plug the deficit.

Arkansas, Pages 7 on 01/01/2013

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