When it comes to funding Arkansas Works, the majority may not rule.
A comparatively small number of Arkansas lawmakers could deny health insurance to more than a quarter million low-income Arkansans.
Never mind that a large majority of their colleagues favor the Medicaid expansion program that is supposed to replace Arkansas' "private option."
Gov. Asa Hutchinson goes into this week's fiscal session of the Arkansas Legislature with solid majorities in the House and Senate supporting the reformed program.
In last week's special session, Senate members voted 25-10 to approve the restructured and renamed program. House members voted 70-30 for the changes.
Yet, more votes will be needed in both chambers if Arkansas Works is to survive in the fiscal session that started today.
The appropriation requires a super-majority vote, or three-quarters of both houses of the Legislature. That's 27 votes in the Senate and 75 in the House. So, at least two Senate members and five House members who voted against Arkansas Works last week will have to agree to fund the program.
Finding those votes is a daunting challenge for the governor and supporters of this new incarnation of the private option.
Arkansas Works would have the state continue to purchase private health insurance for qualifying lower-income Arkansans with money made available through the federal Affordable Care Act, or Obamacare. The federal government has paid 100 percent of the cost; but, beginning in 2017, the state must pay 5 percent. The state share will increase gradually to 10 percent by 2020.
The program gives access to health care to families that wouldn't have insurance without it. It also benefits hospitals and other providers that might otherwise be providing uncompensated care to these people. Plus, without the infusion of those extra Medicaid dollars, the state would experience a multi-million hole in the state budget Gov. Hutchinson has recommended for the next fiscal year.
Money-saving restrictions adopted last week make Arkansas Works different from the private option and were intended to coax support from opponents. The new plan calls for charging premiums to some enrollees, subsidizing employer-based insurance plans for qualified participants who work and referring unemployed enrollees to job training.
Nevertheless, there are serious holdouts threatening to block the funding.
Funding is top of the agenda for the fiscal session that began this week with warnings from legislative leaders of dramatic cuts in the state budget if Arkansas Works is not approved.
The potential loss of those federal dollars is what prompted House Speaker Jeremy Gillam, R-Judsonia, to release an alternative budget with cuts to funding for public schools, higher education, prisons and other budget items.
This was a plan put together by Gillam and state Rep. Lane Jean, R-Magnolia and co-chair of the Joint Budget Committee, who voted against authorization of Arkansas Works. Gillam voted for the program.
As legislative leaders, they'll certainly influence how the Legislature might cut the state budget to match decreased revenue projections. But theirs was only the first suggestion of how state priorities might have to change if Arkansas rejects the federal Medicaid expansion money.
Gov. Hutchinson has projected a resulting shortfall of more than $100 million in the budget he has proposed for the next fiscal year. Gillam's plan suggests an even larger shortfall.
Whether or not the Legislature will have to factor any shortfall into the state budget will be decided when lawmakers vote on appropriations that include Arkansas Works.
While the appropriation could be blocked in either chamber of the Legislature, the Senate is where most of the attention is focused since just nine senators can stop the funding there.
Ten Republican senators have reportedly said they'll vote against it. Nine have confirmed their intention to the Democrat-Gazette. The nine are Sens. Cecile Bledsoe of Rogers, Linda Collins-Smith of Batesville, Scott Flippo of Mountain Home, Alan Clark of Lonsdale, Bart Hester of Cave Springs, Blake Johnson of Corning, Bryan King of Green Forest, Terry Rice of Waldron and Gary Stubblefield of Branch. The other senator who voted against the program is Missy Irvin of Mountain View.
Two of them -- and five of their House colleagues who voted against the program -- will have to change their minds if Arkansas Works is to be funded.
Commentary on 04/13/2016