To former Arkansas Gov. Mike Huckabee, work requirements, such as the one Arkansas has imposed on some Medicaid recipients, are "a good thing" that can help build confidence in government programs.
His successor, former Gov. Mike Beebe, sees another value in the provision: Helping Gov. Asa Hutchinson win support in the Republican-controlled Legislature for preserving the expansion of Medicaid to low-income, nondisabled adults.
"While I might have tried to do it a different way, Gov. Hutchinson was faced with a pragmatic situation, and he needed to continue the program," Beebe said.
Beebe, a Democrat, and Huckabee, a Republican, spoke about the work requirement and other health care issues, including ones that each of the two governors dealt with during his tenure, at the Statehouse Convention Center in Little Rock on Monday evening.
The event was sponsored by the Clinton School of Public Service to celebrate the 20th anniversary of the creation of the Arkansas Center for Health Improvement.
The former governors were introduced by Hutchinson. Former Gov. Jim Guy Tucker, who preceded Huckabee, also attended.
More than 12,200 Arkansans have lost their Medicaid coverage as a result of the work requirement since the state began phasing it in in June.
The requirement applies to enrollees who were made eligible for Medicaid in 2014 when the state expanded the program to cover adults with incomes of up to 138 percent of the poverty level.
Under the so-called private option, created during Beebe's tenure, most enrollees receive the coverage through private plans, with the Medicaid program paying most or all of the premium.
"The overwhelming majority of the people on the private option are already working," Beebe said. "They were the working poor."
Providing the coverage through private plans created the "political hook for some people that made it more palatable" and helped win support in the Republican-controlled Legislature to expand Medicaid as allowed under the 2010 Patient Protection and Affordable Care Act, Beebe said.
In the same way, he acknowledged the hurdle that Hutchinson has faced in preserving the expanded coverage, which requires a three-fourths majority each year in the state House and Senate.
"Gov. Hutchinson's continuation for the private option is something all ought to be very grateful for," Beebe said.
As for the work requirement, he said he recognizes the need to not let the "perfect be the enemy of the good."
"I think you need to be very careful and make sure you don't inadvertently drop worthy people out of the system, but I will acknowledge sometimes the pragmatic nature of getting 90 percent of a loaf is worth doing," Beebe said. "Now let's go back and make sure we're fair to the other 10 percent."
Huckabee said a similar requirement, imposed on the state's welfare recipients during his tenure, was also contentious but had good results.
"When the dust was settled, people went to work," he said.
Before the requirement was added, many recipients "could work, but didn't," Huckabee said.
He said state workers were surprised to discover that many recipients didn't even own alarm clocks.
"They said, 'What's an alarm clock? I don't have one of those,'" Huckabee said. "They never had to wake up at a specific time to be at a job at a specific hour."
Most of the discussion focused on health policy issues the two former governors dealt with during their tenures. Huckabee cited the creation of ARKids First, which extended health coverage for children in low-income families, as his proudest achievement, while Beebe said his was an initiative to control health care costs.
Both former governors spoke about the challenges ofin working with a Legislature controlled by the opposing political party.
The state's Clean Indoor Air Act of 2006, which banned smoking in most businesses, was opposed by the restaurant industry. But Huckabee said restaurant owners later discovered that the ban reduced their cleaning bills and helped them make more money by turning over tables more quickly.
"It took a while to get those thank-yous, but it was very much worth it," he said.
Metro on 12/04/2018