Governor Mike Beebe On Board with Medicaid Expansion
Governor Mike Beebe has thrown his full support behind Medicaid expansion here in Arkansas. The following article may be found in today’s Arkansas Democrat-Gazette and is written by Charlie Frago.
Assured, Beebe urges Medicaid expansion
LITTLE ROCK — Gov. Mike Beebe said Tuesday that he supports state expansion of Arkansas’ Medicaid program by 250,000 people, substantially swelling the rolls of the $4.8 billion program that already covers more than one-fourth of the state’s population.
“I’m for it. I think it’s good for our people because it’s helping folks that don’t have insurance now that are out there working their tails off. They’re not sitting on a couch somewhere just asking for something,” Beebe told reporters about the federally backed expansion at the Capitol.
A written federal assurance — received earlier this month — allowing the state to opt out of the expansion satisfied his concerns, said Beebe, who had said previously that he was “inclined” to move forward.
Still, if three-quarters of state lawmakers don’t agree with him, “it’s not going to happen anyway,” Beebe said, referring to the super-majority of the Legislature required to approve the spending.
Republican leaders said their party remains strongly opposed to expansion.
“None of our previous concerns have changed,” said Sen. Michael Lamoureux, a Russellville Republican, who along with several other GOP members wrote to Beebe asking him to slow down the process.
Lamoureux said that adding a quarter of a million people to Medicaid will be hard to undo, no matter what flexibility the federal government allows.
“I don’t think that it’s very likely that once we extend Medicaid to all those people that we will take it away. It may be irresponsible to present it that way,” Lamoureux said.
The federal money and anticipated economic stimulus from expansion won’t eliminate an estimated $320 million to $340 million Medicaid deficit, Beebe said.
Tr i m s t o the program will have to be made, the governor said. Beebe has recently said that tax increases aren’t a viable option in the current political climate.
“There will have to be some cuts,” Beebe said. “Obviously, things that are discretionary. We’ll try to do it in a way that is the most palatable and hurts the people the least.”
Optional Medicaid services include ARKids B, the healthinsurance program for children in families that earn up to 200 percent of the poverty level, nursing home and home-based care for seniors, and prescription drug benefits.
Beebe said it is too early to speculate on what might be cut, but he has asked state Department of Human Services to prioritize options for the chopping block.
If the state doesn’t take the federal offer on expansion, Arkansans — through their federal taxes — will be paying for Medicaid expansion in states like California or New York without enjoying any of the benefits, Beebe said.
“This is important on its merits. We got to pay these taxes. … Do I let Arkansas be left out when we’re paying our fair share? I don’t think that’s right,” he said.
House Minority Leader Bruce Westerman, R-Hot Springs, said increased taxes — either federal or state — are precisely the reason he opposes expansion.
“At least he’s acknowledging that it’s Arkansas tax dollars that will be paying for expansion,” Westerman said. “I still have a problem with putting the state on the hook for all the extra funding down the road when the governor is out of office.”
The federal government has promised to pick up the entire tab for expansion until 2017. By 2020, the state would be responsible for 10 percent of the cost.
Many of the new enrollees — who can earn up to 138 percent of the poverty level — would be working poor who are currently uninsured. A family of four that earns up to $31,809 or an individual who earns $15,415 would qualify.
The federal government would pay the state about $900 million extra per year. The Department of Human Services estimates that the state would save $372 million between 2014 and 2021 because some existing programs will qualify for the higher federal match, reducing uncompensated care and increasing tax revenue.
Currently, Arkansas Medicaid covers about 780,000 people. The state now pays about 30 cents of every Medicaid dollar.
Beebe said he has talked to Republicans who are at least somewhat receptive to expansion.
“Some of them are openminded about it. They don’t want us to have to pay these taxes and all the money to go to New York or California or Michigan or these other states and Arkansas to be left out,” Beebe said.
No Republican has told him that they’re wavering, Westerman said. And Lamoureux noted that members of Beebe’s own party, such as Democratic Sen. Steve Harrelson of Texarkana, oppose it.
What the Legislature will do in January is unknowable two months before an election that will bring dozens of new faces to Little Rock, Lamoureux said.
“Anything that happens right now either is political or will be perceived as political,” Lamoureux said. “We’ll take our time and wait.”
Hospitals, especially struggling rural facilities, would benefit as would all who already have insurance coverage because “it attacks the uncompensated-care issue,” Beebe said.
Uncompensated, or charity, medical care cost Arkansas hospitals $338 million in 2010, according to a study by the Arkansas Hospital Association.
The Medicaid expansion is allowed by the Affordable Care Act, which leaves the decision up to individual states. Several Republican governors have said they won’t participate. There is no deadline for participation, but Beebe said the letter from Centers for Medicare and Medicaid Services, a federal oversight agency, confirming the state could opt out during tough fiscal times, clinched the deal for him.
Beebe said he “wanted to make sure we were masters of our own fate.” The Centers for Medicare and Medicaid Services’ response “satisfies my big objection to it.”
The centers’ letter is “just a letter,” Lamoureux said. Federal policy could change with the Nov. 6 election or because of growing national debt.
Lawmakers need to be informed about the benefits by Thanksgiving, Beebe said.
“How does it affect people? How does it affect hospitals? How does it affect physicians. … They’re free to make up their own mind. I’m just going to tell them the truth.”
Front Section, Pages 1 on 09/12/2012