Gov. Asa Hutchinson signs continuation of Medicaid expansion into law, but funding fight looms next week (UPDATES) | Arkansas Blog

Gov. Asa Hutchinson signs continuation of Medicaid expansion into law, but funding fight looms next week (UPDATES)

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HUTCHINSON: "There's a fundamental principle of government that we need to deal with, and that is that the minority should not derail the expressed will of the majority.”
  • HUTCHINSON: "There's a fundamental principle of government that we need to deal with, and that is that the minority should not derail the expressed will of the majority.”

Gov. Asa Hutchinson
today signed the "Arkansas Works" legislation into law in a public ceremony at the Capitol. 

The law continues the private option, the state's unique version of Medicaid expansion, which uses funds available via Obamacare to purchase health insurance for more than 275,000 low-income Arkansans. 

The House and Senate passed the bill this morning, on the final day of the three-day session devoted to health care. 

The governor called it a "practical solution for the state of Arkansas."

Hutchinson applauded the law as a bipartisan compromise effort, mentioning tweaks to the legislation that he had included at the behest of the Democratic caucus. The governor noted that a majority of Republicans voted for the bill; along with Democrats, that made for the huge majorities in both chambers that passed the bill into law this morning.   

“A consensus was arrived at that a bipartisan group of legislators, a majority from both sides," Hutchinson said. "That's what the people of Arkansas are yearning for." 

The hard part comes next week. The small minority of Tea Party legislators who voted against the bill are threatening to hold the entire Medicaid budget hostage in order to try to kill the private option. The appropriation for the Medicaid budget — that's not just the private option but all Medicaid services, including children on ARKids, the elderly in nursing homes, the disabled, and medical care for foster children — is generally thought to require 75-percent approval in both houses. Theoretically, just nine senators (or twenty-six in the House) could shut down all of that funding if the overwhelming majority didn't give in to their demands.

"There's a fundamental principle of government that we need to deal with, and that is that the minority should not derail the expressed will of the majority,” Hutchinson said. 

The governor continued: 

That has not happened in Arkansas’ history. There are tools of the minority, and they’re important tools that can be operated with. But when it comes to a policy that is set by a majority of both parties, and it comes to the funding of that policy, a minority should not derail the policy. I would not want the Democratic members of the legislature to derail a Department of Corrections appropriation because you disagree with the policy. I would not want the Republicans to derail funding for an agency of government because they disagree with a policy that’s been adopted by the majority of the legislature. 
The governor made reference to the alarming comments from Sen. Bart Hester in this morning's D-G that he was willing to play a game of chicken with the entire Medicaid program and "the only thing that's going to bring resolution to this is a crash." Hutchinson expressed confidence that he could win supermajority support for the appropriation despite the bluster from aginners: 
My objective in the coming days is to win the funding for the Department of Human Services that would include the Arkansas Works legislation that has been adopted. It is my responsibility as governor to avoid what some have described as an inevitable crash. I want, as governor to avoid that crash. I want to keep the wheels of government on the road, and progressing and working for the people of this state. I’m confident that this can be done.
Hutchinson said that opponents of Arkansas Works voted against it “out of conviction, they did it out of pure motives, they voted their conscience, and I applaud them for it.”

However, he said that threatening to shut down the government for a small minority to get their way was “a bad precedent for the House and Senate. … I do not believe that we ought to be heading for a crash in this state. We ought to be heading for a consensus.”

I asked Hutchinson whether he would consider the legal arguments that some have put forth (and that the governor's office has at least explored) that the appropriation could pass with a two-thirds or simple majority  "I want to win a three fourths vote," he said. 

Senate President Jonathan Dismang said that he would not consider the appropriation passed unless it got the 75-percent supermajority. "Since I've been here we've recognized the three fourths requirement," he said. "I think that still stands and that's how we're going to operate going forward."

Hutchinson said that he would not use the separate question of implementing managed care for certain traditional Medicaid populations as a bargaining chip to try to secure votes. Some lawmakers who voted NO on Arkansas Works but are considered possible swing votes — such as Missy Irvin in the senate and Michelle Gray in the House — oppose the governor's managed care plan and have backed an alternative known as DiamondCare. Would the governor adopt their DiamondCare plan if they would be willing to vote for the appropriation? "No," he said. 

I asked whether the governor would make deals with lawmakers to secure votes that weren't directly related to the Arkansas Works policy itself. "I haven't even begun discussions with the legislators," he said. "What I think needs to be done is that we recognize that a majority supported this policy and that if we fail to approve the funding then where do we go from there? That's the beginning point of the conversation. I know these representatives — they're people of conviction and they're not interested in coming in and swapping votes, they're not interested in coming in and saying how much can we get for this or that. They're very practical people and I'm hopeful we can have conversation about the merits of this, the policy, and what's the right solution." 

Hutchinson gave a clear summation of the kamikaze approach of the aginners. They might have the votes to block the appropriation and potentially shut down the government, but they don't have anywhere close to the votes to actually pass another appropriation in its place: 
Under our current interpretation of the constitution, you have to have a three fourths vote to pass an appropriation bill. If you have nine or ten that vote against it on the senate side, than you don’t pass your appropriation bill. If that does not pass then you have to arrive at some consensus for a DHS appropriation that will pass. The question would be what can get three fourths vote. Will the Democrats, and the Republicans who have supported Arkansas Works, will they vote for an appropriation bill without Arkansas Works. You could have a standoff where you have neither side able to get a DHS appropriation passed because you can’t get the three fourths vote.
"That’s a standoff," the governor continued. "That’s what leads to government shutdowns in Washington. We’ve never had that in Arkansas. I don’t expect to have that under my watch."

Hutchinson added: "Those are the consequences that are real, and it’s real tens of thousands of people in Arkansas who are dependent upon these services. "

Support for special health care reporting made possible by the Arkansas Public Policy Panel.


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