BETWEEN THE LINES: Fiscal Matters Set Tone For Legislature

Who would really want to cut Medicaid, the lone avenue for health care for so many of Arkansas’ struggling residents?

Apparently, new Republican legislative leaders don’t, although Gov.

Mike Beebe has proposed $138 million in Medicaid cuts for fi scal 2014.

Nor do these two - Michael Lamoureux, the incoming president of the state Senate, and Davy Carter, the House speakerdesignee - expect their respective chambers of the Legislature to make any Medicaid cuts.

That’s what they said this week in a joint news conference to preview the upcoming session, which convenes next week amid great anticipation.

Republicans “control” both chambers of the Legislature for the fi rst time since Reconstruction. Their control is qualified because it is by such a slim margin that Carter secured his leadership post on a vote from mostly Democrats and a relative few Republicans.

Nevertheless, the new mix makes this session unusually challenging. Plus, the session is further complicated by a second Medicaid issue - whether to expand the program to cover more of the state’s poor.

The state’s numbercrunchers suggest the move would actually ease the problem with the state’s existing Medicaid shortfall, since the federal government will foot almost all of the bill.

Notably, the cuts to the existing program proposed by Beebe’s administration include removing more than 10,000 people from nursing home care, which the governor himself wants to avoid.

Gov. Beebe, the state’s term-limited Democratic governor, also met with the media on Monday.

He detailed his long-held philosophy against using one-time money, such as the dollars accumulated in a state surplus, to pay ongoing obligations like Medicaid.

Those ongoing obligations remain after the one-time money is spent. The state must plan for that day, too, he argued.

He reluctantly balanced his proposed budget, however, with just such use of some of the state’s surplusdollars; and the legislative leaders are arguing more of the $300 million surplus should be spent to avoid Medicaid program cuts.

Beebe, citing obligations to other elements of the state budget, doesn’t want to spend still more one-time money on Medicaid. Therein lies the philosophical face-off for the coming session.

Monday’s press preview suggested this session is really destined to be about managing the state’s money, despite the fact this Republican-leaning Legislature will surely bring up all manner of social issues, too.

Covering the Medicaid shortfall is a huge part of the challenge. Expansion of Medicaid to more Arkansans will be a major element, too, although neither of the Republican leaders seem too anxious to get into that discussion. Beebe favors the expansion, as do the state’s hospitals and others in the health care delivery business.

The expansion would increase Medicaid participants by 250,000 in this state. While the federal government will pay the full tab for three years, the state would gradually pay part, up to 10 percent, of the cost.

Making the challenge all the more dift cult for Beebe and others who back the expansion plan is the fact that approval requires athree-quarters vote of both houses of the Legislature, which was hard enough to achieve when Democrats dominated and partisanship was less a factor.

Some Republicans wanted to push the expansion discussion off to a special session; but Beebe, the one with authority to call a special session, has said it should be resolved in the regular session.

The current stall from some lawmakers is to try to get the feds to allow Arkansas more fl exibility, perhaps reducing eligibility, in this nationwide program to expand Medicaid. Beebe will ask for the fl exibility but the feds aren’t likely to let Arkansas play by diff erent rules than other states must.

What all of this portends is a slow start for the meat of the legislative session.

Obviously, there are lots of details for new and old lawmakers to absorb before they reach any momentous decisions about this budget.

Part of the dift culty will be a flexing of partisan muscle by Republicans and by Democrats, but the bigger task involves the sizable learning curve about complicated, intertwined fi scal issues.

BRENDA BLAGG IS A FREELANCE COLUMNIST AND LONGTIME JOURNALIST IN NORTHWEST ARKANSAS.

Opinion, Pages 5 on 01/09/2013

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