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Tuesday, April 16, 2013

The House approves Medicaid expansion, 77-23

Posted By on Tue, Apr 16, 2013 at 10:14 AM

FOR MEDICAID: Advocates of Medicaid expansion again demonstrated outside the House this morning.
  • Brian Chilson
  • FOR MEDICAID: Advocates of Medicaid expansion again demonstrated outside the House this morning.

GREEN MEANS GO: Board lit up with 77 ayes.
  • GREEN MEANS GO: Board lit up with 77 ayes.
The Arkansas House voted, 77-23, today to approve the appropriation bill, HB 1219, to pay for a federally financed expansion of Medicaid health insurance coverage under President Obama's health care legislation.

The House had fallen six votes short of the 75 needed in the first try yesterday. These changes accounted for the change from 69 yesterday:

Voting aye today after no votes or non-votes yesterday: Les Carnine, Ann Clemmer, Jon Eubanks, John Hutchison, Allen Kerr, Kelly Linck, Stephanie Malone, Sue Scott, and Mary Lou Slinkard. (Clemmer and Malone didn't vote; Slinkard voted present.) Flipped to no from aye yesterday: Stephen Meeks

The full roll call here.

House Speaker Davy Carter had wrangled the votes and expected the outcome. He had a prepared statement ready minutes after the vote:


I commend my colleagues who have just cast a difficult vote in favor of the ‘private option’. With their support, Arkansas now leads the nation with a conservative alternative to the policy forced upon us by the federal government.

The bill now goes to the Senate, where the enabling legislation drew 24 votes, with 27 needed for approval of the appropriation bill. Under the Constitution, the bill can't be read twice in the same day, so it will be read in the Senate today and a vote will come tomorrow. UPDATE: The enabling legislation got 28 favorable votes in the Senate this afternoon, a favorable indicator for tomorrow. One senator, however, Missy Irvin, said her "aye" vote was a mistake.

NOW COME THE TAX CUTS: Gov. Mike Beebe, meeting reporters after, said tax cut bills will now move forward with Medicaid expansion vote.
  • David Goins/Fox 16
  • NOW COME THE TAX CUTS: Gov. Mike Beebe, meeting reporters after, said tax cut bills will now move forward with Medicaid expansion vote.

The debate:

As yesterday, Rep. Duncan Baird merely explained that the bill was the Department Human Services appropriation. Today, unlike yesterday, there were many speeches for and against the legislation, bitter ones from a couple of opponents.

Republican Rep. Nate Bell of Mena said there'd been "threats and intimidation" made against members and families. "Do you want to be on the side of threats and intimidation or doyou want to vote what's in your heart." Bell perhaps referred in part to reporting that his wife has been employed by a lobby, Americans for Prosperity, working against the bill.

Rep. John Payton of Wilburn said there was a "threat" in the halls, a threat he connected to soldiers serving in foreign wars. He said General Improvement Funds were being used to coerce votes. (This is the surplus money traditionally divvied up among legislators.) He said the GIF money would be better directed to hospitals.

Rep. Bruce Westerman, an early sponsor of the private option who bailed out last week, against spoke in opposition because of the uncertainty in the numbers. He identified four groups in the chamber — Democrats who've consistently supported Medicaid expansion; Republicans who've consistently opposed it; Republicans who've opposed expansion, but researched the issue and decided private option was the best route forward, and Republican colleagues who've opposed expansion who'll vote for it, not because it's the best route forward, but for some other reason. He said he didn't respect the last group. And he fired at the press who tried to discredit him. And he challenged the hospitals to find opponents to run against him. "I'm going to do the right thing anyway," he said. "Shame on you," he said to lobbyists who'd worked to elect candidates who ran on platforms in opposition to Obamacare. "Is this vote worth 30 pieces of silver?"

Rep. John Burris, the Republican who's led the fight for the so-called private option alternative, responded directly to Payton. He said he'd voted against members-own appropriations for GIF money. He said the money is distributed equitably. "I know we're all under pressure. That's a lot different from threats," he said. He said he didn't question the sincerity of anyone on either side of the issue and that all were voting for "the right reasons."

Rep. Randy Alexander, who'd been on the fence, came out against the bill after again saying it was the best option available. He listed several pluses for the private option. "So why vote no today?" he asked. He again said more time was needed — at least two full weeks — for constituents to be heard from. He said they don't have the access to information and lobbyists that legislators have.

Republican Rep. Sue Scott of Rogers, who voted against the bill Monday, spoke for the bill today. She invoked the needs of small businesses, hospitals and working people. "I've had too many phone calls from too many hard working people, not lobbyists," she said.

Rep. Kim Hammer of Benton also opposed the bill. He said questions about the bill remain unanswered, some generated by a town hall meeting he participated in last night. He mentioned that about 60 percent of those in attendance favored the bill.

A single Democrat spoke, Rep. John Edwards of Little Rock. He spoke to Payton as a war veteran himself. He said the bill created a better Arkansas and could "catapult Arkansas into a leadership position" in health care. Reps. Mark Biviano of Searcy and Rep. Andy Davis also spoke for the bill.

Virtually every lobbying interest in Arkansas was behind the bill, from businesses to public agencies that wanted the additional federal money to provide relief for other state government and to provide a margin for tax cuts. The primary lobbying force against the measure was the Koch-funded Americans for Prosperity, which spent a huge sum in 2012 to elect many of the conservative legislators voting on the bill in the House and, next, the Senate.

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