LITTLE ROCK — Gov. Mike Beebe said Wednesday that he will ask the federal government to let Arkansas tailor a potential Medicaid expansion to meet the state’s needs.
Republican legislative leaders asked Beebe to explore whether the state has options earlier this month. The federal Department of Health and Human Services said in December that states may choose to do a partial Medicaid expansion but thatthey wouldn’t get the three years of 100 percent federal funding provided under the federal Patient Protection and Affordable Care Act.
Beebe spoke with reporters after a meeting of the Po-litical Animals Club of Little Rock at the Governor’s Mansion. He said he is trying to set up a meeting with Health and Human Services Secretary Kathleen Sebelius during the winter meeting Feb. 24-27 of the National Governors Association in Washington, D.C.
“It’s tentative because we don’t know yet what the lay of the land is going to look like,” he said.
Expanding the state Medicaid program is allowed, but not required, under the Affordable Care Act. It is expected to be one of the top issues of the 2013 legislative session.
The expansion would give an additional 250,000 poor Arkansans access to Medicaid services. The federal government would cover 100 percent of the cost for the first few years, with the state share gradually increasing to 10 percent of the cost by 2020.
Under the original federal plan, Arkansas would have to provide Medicaid to people with income up to 138 percent of the poverty line or forgo additional federal Medicaid funds.
House Speaker Davy Carter of Cabot and Senate President Pro Tempore Michael Lamoureux have said it will be difficult to pass a take-itor-leave-it federal Medicaid expansion in Arkansas.
Both said Wednesday that they were not aware the governor was working to arrange a meeting.
“The wiggle room I hope for is they would let us negotiate our own agreement,” Lamoureux said. “I just wish they would let us determine what mix is best for Arkansas.”
House Republican leader Bruce Westerman also said he wasn’t aware of a planned meeting.
“My understanding right now is we either expand or we don’t expand is what the federal government has told us, but if they can work something else out we’re open to hearing what they’ve got.”
Expanding the $5 billion Medicaid program would require a three-fourths vote in the House and Senate. A three-fourths vote would require 75 votes in the 100-member House and 27 votesin the 35-member Senate.
Medicaid already covers about 780,000 people in Arkansas, mostly older people, children and the disabled.
Three days into the 2013 legislative session, lawmakers said they still have too many questions about the longterm effects of the Medicaid expansion, including what happens if the federal government changes its reimbursement rate.
Beebe said it is too early to know whether the department is willing to budge on itsall-or-nothing stance. He said it’s worth a try because the federal government appears more open to state proposals. Monday, for example, it unveiled newproposed Medicaid rules that would allow states to charge copayments for Medicaid recipients for prescription drugs and nonemergency trips to emergency rooms - changes many governors had sought.
The federal response that they would consider copays “is an indication that they are not as rigid as they once were, or as many people thought they were,” Beebe said. “Whether that goes beyond copays remains to be seen.”
Beebe said the request for more flexibility isn’t specific to Arkansas.
“You know governors; they like to be in charge and theylike the state to have as much unique flexibility as possible,” he said.
Beebe said he could support a proposal championed by Republican Arizona Gov. Jan Brewer on Monday when she announced that Arizona would expand its Medicaid rolls.
Brewer said that Arizona would accept expansion with a “circuit breaker” in state law to automatically roll back enrollment if the federal government changes its reimbursement rate and makes states responsible for more than 10 percent of the cost of the new enrollees.
“If it makes people feel better to put it in the legislation, we’ve already got that ability right now without a circuit breaker, but sometimes it makes folks even more comfortable if they had a circuit breaker,” Beebe said.
The federal government already has assured Beebe that if the state finds it cannot afford its share of the expansion, Arkansas can reduce eligibility again.
“Some people may find it easier to make it automatic, where they wouldn’t have to vote a second time, and that’s certainly an option,” Beebe said.
Front Section, Pages 1 on 01/17/2013