LITTLE ROCK — The Senate bill to repeal and replace the Affordable Care Act is an improvement over the version the House approved last month but it still needs work, Gov. Asa Hutchinson said Monday.
“It is in a number of areas an improvement on what came out of the House, and that’s what we’re looking for, is an improvement,” Hutchinson told reporters after giving a talk at the Arkansas Public Safety Communications Conference in Little Rock.
“I think really the message to the public is: Don’t panic. There’s a lot of work that needs to be done,” he said.
Hutchinson spoke before the release Monday afternoon of the Congressional Budget Office’s report on the bill, which estimates that it would cause 22 million people to lose health-care coverage by 2026. The CBO has estimated that the House bill would cause 23 million people to lose coverage by 2026.
Arkansas Sens. Tom Cotton and John Boozman have not said whether they will vote for the Senate bill, which was crafted behind closed doors by a group of Republican senators that included Cotton.
Hutchinson said improvements in the Senate bill include greater flexibility for states, more supplemental funds for states and a “more fair” system of tax credits to help people buy insurance.
But he said he has spoken with Cotton about aspects of the bill that concern him, including a provision that would wind down federal funding for states’ Medicaid expansion programs.
The federal government’s share of the cost of Medicaid expansion began at 100 percent and is gradually decreasing until it reaches 90 percent in 2020, at which level it is supposed to stay indefinitely under current law.
But under the Senate bill, in 2021 the federal government would begin reducing its share of the cost by 5 percentage points per year until 2024, when it would no longer provide any funding for Medicaid expansion programs beyond states’ normal Medicaid matching rates. The federal government’s normal matching rate for Arkansas is 70 percent.
Arkansas’s Medicaid expansion program has provided health-care coverage to more than 300,000 Arkansans earning up to 138 percent of the federal poverty level. A trigger the state Legislature wrote into the program calls for it to end if the federal matching rate is ever changed from the levels set under the Affordable Care Act — although lawmakers could repeal that provision before 2021.
“Even though the transition time is way off in the future, there is a shift and a reduction long-term in federal commitment to the expanded Medicaid coverage,” Hutchinson said. “That’s a really tough call in terms of the direction of America, not just Arkansas.”
The bill would allow people earning less than 100 percent of the federal poverty level to obtain federal subsidies to buy insurance, which they cannot do under current law because the Federal Affordable Care Act envisioned that those people would be covered under Medicaid expansion.
Hutchinson said the key question is, “Will they move successfully onto the exchange?”
He said the bill also would provide supplemental money to states for things like high-risk pools and innovation.
“We need to measure closely as to how that’s going to meet the needs and offset what could be a cost shift in the expanded population on the Medicaid side,” Hutchinson said.
Also Monday, the group Faith Voice Arkansas held a news conference in North Little Rock to call on Boozman and Cotton to vote against the bill, which they said would hurt the poor.
“This bill turns its back on the very same people toward whom Jesus turned his face,” said the Rev. Preston Clegg, pastor of the Second Baptist Church Downtown in Little Rock.