Wednesday, April 17, 2013

TOP STORY >> Carter gets more votes on Medicaid

By JOHN HOFHEIMER
Leader senior staff writer

Eight lawmakers switched their votes on House Bill 1143 overnight as the House, on Tuesday, approved the appropriation of federal funds for the private insurance option to Medicaid expansion.

Some lawmakers may have had a change of heart or bowed to constituents, while Gov. Mike Beebe and House Speaker Davy Carter (R-Cabot) may have twisted an arm or two.

The bill, which needed 75 votes, got 77, advancing the likelihood of healthcare insurance for about 250,000 working poor between the ages of 18 and 65.

On the Senate side, vote counters say the private option bill has 26 votes going into today’s probable showdown, but needs one more.

If 27 of the 35 senators vote for the measure today, then Gov. Beebe has promised to sign it into law. The plan is billed as an innovative alternative to Obamacare’s Medicaid expansion that could provide a road map for other states struggling with the issue.

“Leadership is trying hard to pass this,” Rep. Jim Nickels (D-Sherwood) said Tuesday evening.

Beebe got Health and Human Services Director Kathleen Sebelius’ blessing for the private option.

If there’s anything Arkansas Republicans like less than Medicaid, it’s Obamacare — the Affordable Care Act — out of which Medicaid expansion was born. But by letting federal Medicaid funds pay for premiums and covering residents through private health insurance companies instead, Republicans had just enough distance and cover to promote or vote for the law.

As an appropriations bill, it needs 75 votes —three-quarters of the 100 representatives — but had only 69 after Monday’s first vote, with 28 nays and three voting “present” or not voting.

Rep. Patti Julian (D-North Little Rock) gave credit for passage of the bill to small rural hospitals, which were busy on the phones lobbying for it. Some claimed it was a matter of life and death for their hospitals.

Rep. Doug House (R-North Little Rock) said he had answered more than 1,000 e-mails on the issue. He says he’s a staunch opponent of Obama-care and fears Obama’s policy will cause the collapse of the federal government before the policy can be replaced.

“The national debt is $17 trillion and rising,” House said. But he wants to keep the small hospitals running until then.

With the exception of Rep. Joe Farrer (R-Austin), all area state representatives — Democrats as well as Republicans — voted Tuesday for the appropriation.

They included Democrats Julian, Nickels, Rep. Mark Perry of Jacksonville and Rep. Walls McCrary of Lonoke, as well as House Speaker Carter, a Republican.

Carter kept other important bills like Big River Steel and a $150 million tax cut bottled up behind the healthcare bill, “encouraging” members to pass the appropriation bill so they could move on to the others, some observers said.

“At the end of the day, the choice for the private option was the best choice on the table,” Carter said in a statement. “It saves our small businesses from over $25 million worth of penalties. It also prevents our Medicaid rolls from increasing.”

“I’m also very pleased that we passed over $150 million worth of tax cuts on the House floor. These include reducing the state income tax, increasing the standard deduction, reducing the tax on capital gains, reducing the sales tax on energy for manufacturing, and reducing the sales tax on groceries if budget conditions allow. If these measures are enacted, every single Arkansan will see the positive impact next year,” he said.

Carter also praised the appropriation measure supporting the Big River Steel project. The enabling legislation passed last week outlines the incentives to bring a $1.1 billion investment to Mississippi County.

Construction is expected to begin late this year.

“This bill decides whether Arkansas creates jobs or loses them, whether our people get access to health care or not, and whether our federal tax dollars come back to Arkansas or instead go to other states,” according to the Democratic caucus.

“This has been a long and carefully discussed plan that both sides agree is the best option for Arkansans. The private-option plan ensures that about 250,000 citizens have the choices they want and the coverage they deserve starting January 1, 2015,” Carter added.

“This is a major step forward in getting the private option fully implemented and developed,” Perry said. “Arkansas is going to lead the nation.”