Wednesday, January 23, 2013

TOP STORY >> Medicaid issue still undecided

Leader senior staff writer

With legislators settling into committee assignments, many of them learning the ropes for the first time, Medicaid expansion is on everyone’s minds, but not yet on the agenda.

It seems likely that some form of Medicaid expansion — part of President Obama’s controversial Affordable Care Act — could be passed this session.

Expansion would add 250,000 people to Arkansas’ Medicaid rolls, but with initial federal help, would save the state $100,000 in 2015, growing to $500,000 a year by 2021, according to Dr. Andy Allison, state Medicaid director.

That’s largely because the state Medicaid match, currently 30 percent, would be reduced at first to zero percent, then growing to 10 percent over time.

Half of Arkansas’ pregnancies are covered by Medicaid, so the state pays 30 percent of those costs. But under the new plan, the federal government would pay 100 percent the first three years of the plan, and then gradually up to 10 percent of that cost would be borne by the state.

Republican opponents to the expansion say those projections are incorrect and some suggest that changing the income eligibility, the expansion would be available to fewer people and more affordable.

Dr. Joe Thompson, the state health director, spoke to the House Public Health, Welfare and Labor Committee on Tuesday. Members heard about the amount of uncompensated care at UAMS and the amount of help it would get from so-called Obamacare and Medicaid expansion.

The Medicaid expansion is part of the president’s Affordable Care law and would serve four currently unserved, uninsured pools of clients —Medicaid coverage for pregnant women, increased hospital benefit coverage, limited coverage for 19- to 64-year-olds and a limited package of benefits for those 65 or older not served by Medicare.

State Rep. Mark Perry, D-Jacksonville, says Medicaid expansion is currently as-signed to the House Public Health Committee to which he is assigned.

He said that so far he’s not seen evidence that Republicans would seek to alter or replace the bill.

“I’m sure other options and variables will come out of that,” Perry said. “They will probably start taking shape over the next two or three weeks.”

Perry said that reducing eligibility for the program would reduce the cost, “but how many other underserved people would be left (uninsured).”

The state owes the federal government about $300 million in Medicaid matching money, and the state will have to use surplus general revenue funds to pay that off, according to state Rep. Walls McCrary, D-Lonoke.

Some legislators want a special session to deal with Medicaid expansion, according to Rep. Patti Julian, D-North Little Rock. They have asked to governor to get a ruling from Washington on whether partial Medicaid expansion is an option. She said early indications are that it is not.

They also are trying to get the numbers nailed down better. Some have challenged the numbers put forward by the state.

Otherwise, legislators have just been taking care of a bunch of housekeeping appropriation bills.

McCrary, who is on the House Transportation Committee, said a bill to include the White County portion of U.S. Hwy. 67 as part of Arkansas’ Rock ’n’ Roll Highway was voted out of committee Tuesday with a “do-pass” recommendation.

Several area legislators had not returned calls by deadline.