Brenda Blagg: Back in session

Lawmakers making changes to Medicaid expansion plan

Arkansas lawmakers returned to Little Rock this week to end one session and begin another.

Additional tweaks to Arkansas' Medicaid expansion program top the agenda. Legislators nonetheless plan to finish their business by week's end.

That business will set the stage for Arkansas to seek additional waivers from the federal government on how Arkansas conducts the program, which is derived from the federal Affordable Care Act, or Obamacare.

Yes, that's the same Obamacare the U.S. Congress is wrestling with, the program that could change drastically, or not, depending on which forces ultimately prevail. At least some of the people who have been trying to kill the program since its inception have come to realize that many of its provisions are popular with Americans.

It really isn't clear just yet what, if any, changes may may come to the federal health care program.

Meantime, Arkansas is proceeding with its plan to ask the Trump administration to allow additional waivers here.

It's confusing, but what we're talking about is the Arkansas program Gov. Asa Hutchinson renamed "Arkansas Works" and persuaded reluctant lawmakers to embrace.

It is the current iteration of what had been Arkansas' "private option," which used federal dollars to buy insurance for eligible Medicaid enrollees.

What the Legislature is doing now is intended to reduce eligibility, shifting about 60,000 people out of Arkansas Works. They could still get subsidized health insurance through the state's health insurance exchange, but would no longer get free coverage.

One more change under consideration would impose work requirements of some enrollees in Arkansas Works.

The change in eligibility is all about the underlying cost to the state government.

This is the first year Arkansas must pay part of the cost of the expanded Medicaid program. The state's share is 5 percent now and will gradually increase to 10 percent by 2020.

Reducing the rolls, which currently sit at more than 320,000 Arkansans, is expected to save the state between $66 million and $93 million over the next four years, according to the governor.

The eligibility shift affects families earning between 100 percent and 138 percent of the federal poverty level. The new income ceiling for enrollment in Arkansas Works would be $12,600 for an individual and $24,600 for a family of four.

There's a real question about how many of the 60,000 Arkansans affected will seek insurance on the exchange. Another question is the impact on premiums that others on the exchange must pay.

All the Medicaid-related issues seem headed for easy passage. But the waivers must get Trump administration approval to be in effect.

Hutchinson also asked lawmakers to consider a few other issues in the special session. One bill called for a study of the Arkansas Health Insurance Marketplace's future. Another moves about $105 million in proceeds from a 2000 tobacco settlement to the state's Long-Term Reserve Fund.

They, too, were advancing rapidly on Tuesday.

For the record, the session the lawmakers wrapped up on Monday was the regular session that had recessed on April 3.

Formal adjournment of a session is generally delayed by a few weeks while the governor's office completes consideration of bills that went to his desk late in the session.

A temporary recess lets lawmakers make any final corrections to new legislation or to consider override of any of the governor's vetoes.

One senator, Sen. Scott Flippo, R-Mountain Home, tried unsuccessfully to get the upper chamber to override a Hutchinson veto. The bill would have barred the Alcoholic Beverage Control from enforcing laws related to gaming or gambling devices.

Flippo got nowhere with his override attempt but the vote briefly enlivened Senate proceedings.

The Legislature did adjourn that session sine die, but the special session actually carried over some of the work.

Among items in Gov. Hutchinson's call were "technical corrections" to incorporate newly enacted laws into the state Constitution.

These are medical marijuana-related laws passed in the regular session to amend provisions of the Arkansas Medical Marijuana Amendment passed by voters last year.

Commentary on 05/03/2017

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