Medicaid expansion survives in Arkansas

Activists Demonstrate In Support Of Medicaid Expansion And The Affordable Healthcare Act
Deborah Dion and other protesters gather in the office of Florida State Rep. Manny Diaz as they protest his stance against the expansion of healthcare coverage on September 20, 2013 in Miami, Florida.
Arkansas struck a creative deal with the Obama administration last year, allowing it to embrace Medicaid expansion under the Affordable Care Act, and bringing coverage to nearly 100,000 low-income Arkansans. This year, however, state Republicans were poised to take it away.
Because of a quirk in the state policymaking process, last year's vote that expanded access needs to be reauthorized this year, and many of the same GOP policymakers who backed the policy in 2013 are facing primary challengers in 2014. Arkansas' state House has therefore voted down Medicaid expansion several times in recent weeks.
In a minor miracle, the policy somehow prevailed today. Apparently, the fifth time was the charm.

The state House on Tuesday voted 76-24 to approve a new round of funding for the so-called private option, resolving the issue that has dominated the fiscal session. The Senate passed the appropriation last month in a 27-8 vote. The House failed in four previous attempts to pass it, each time falling a few votes short of the three-fourths majority, or 75 votes in the 100-member House, needed to approve any appropriations bill. Senate Bill 111 goes next to the governor, who has said he will sign it.

The Arkansas Democrat-Gazette's report quoted one Republican lawmaker, state Rep. Kim Hammer, who had voted against the policy, but ultimately changed his mind.
"There are people who will be hurt if I don't vote for this," Hammer said. "And I don't want to see those innocent people hurt because of that."
But Arkansas isn't the only state with Medicaid expansion news.
In late January, Utah's Republican governor, Gary Herbert, said he was prepared to accept Medicaid expansion, at least in some form, bringing coverage to 111,000 low-income adults in the state.
We're now getting a better sense of what Herbert has in mind.

...Herbert's plan won't be a straightforward expansion of Utah's Medicaid program. Instead, Herbert will ask the Department of Health and Human Services to provide block grants that would allow the state to spend the money on subsidies for Utah residents who make up to 138 percent of the federal poverty line. The three-year pilot program Herbert proposed Thursday, dubbed the Healthy Utah Plan, would provide subsidies to individuals and families based on their ability to work, their household incomes and access to health care through employers, Herbert's office said. Participants would have to make co-payments, and parents with children on Medicaid would have the option to put their whole family on private insurance plans. Recipients of the subsidies would contribute an average of around $420 per year toward their own health care.

It's unclear if the Obama administration will be amenable to Utah's request, and if HHS turns Utah down, it would appear the state would be in a tough position: either figure out some other way to expand coverage or leave $258 million in federal funds on the table and 111,000 low-income Utahans behind.