Legislative budget session begins today: health care in the balance | Arkansas Blog

Monday, February 12, 2018

Legislative budget session begins today: health care in the balance

Posted By on Mon, Feb 12, 2018 at 7:38 AM

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The Arkansas legislature convenes for a 30-day budget session at noon today, with a speech by Gov. Asa Hutchinson at 12:30 p.m. the signal event.

Hutchinson will be in a funny position. He'll be pitching the extension of the mostly federally funded expansion of Medicaid coverage at the same time promising to punish the shiftless welfare chiselers on the program with a stricter income qualification and a work requirement.

The feds haven't yet signed off on the rules changes Hutchinson wants that will allow him to throw 60,000 or so off the Medicaid roles and prove to the fringe supporting his Republican primary opponent, Jan Morgan, that he can be as ruthless as they are.

Except he can't. Because Hutchinson wants to keep the Medicaid expansion alive. while the hard right wants it strangled. The simple reason for Hutchinson's continued support is money. If the far-right takes Arkansas out of the Medicaid program, it will mean a net loss to the state of almost $90 million. You think the buget is tight now, with vital services going begging so that Hutchinson can pile up a reserve for a future income tax cut? See what would happen if the Medicaid infusion goes away, layoffs sweep the health care and related fields, rural hospitals close, poor folks turn to emergency rooms if they don't die for undiagnosed illnesses and lots more happy consequences.

The session, absent super-majority votes by both chambers for departure from script, is only about budget. But the key vote is for the human services budget that holds the Medicaid money. Three seats in the Senate are empty currently. 27 votes of the 35-seat Senate are necessary for passage, precisely the number it got in 2017. If the holdouts can't be offered enough special favors — and a couple of them seem to be asking for bids — then that budget might have to wait for a special legislative session after special elections fill the vacancies.

One more wrinkle: Pharmacists have raised a fearful din over tighter reimbursement policies for people covered by the Medicaid expansion. They claim they are losing money on filling many prescriptions. If their power is sufficient (and they are a powerful lobby) to force a higher expenditure on Medicaid it could be a big deal. It could make the program unsustainable, at least in the eyes of a governor not wanting to be seen as supportive of increases in government spending on poor people.

Joint Budget meets after adjournment. Among the items on its agenda is the Arkansas Supreme Court's request for payment of $135,000 in legal bills and authorization for $500,000 more in the Wendell Griffen lawsuit. The decision of some judges to hire outside counsel for themselves — including $86,000 in spending so far alone for Justice Courtney Goodson — seems likely to prompt a question or two.

No "scheduled events" — the euphemism for the end-around the nominal rule against free wining and dining of legislators — appears on the calendar today. First one listed is a free lunch Wednesday sponsored by the Arkansas Credit Union Association.

There will be others.

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