LITTLE ROCK — People should base their decision on whether to support Medicaid expansion in Arkansas on economics, not politics or personal feelings about the president’s health care reforms, Gov. Mike Beebe said Thursday.
Speaking to delegates at the annual meeting of the Arkansas Hospital Association, Beebe said hospitals in particular would benefit from Medicaid expansion by a reduction in the amount of money they spend on uncompensated care, which he said would lower hospital costs and insurance rates.
He also said the expansion would help keep the doors open at many struggling smaller hospitals, especially in rural areas.
But every hospital in the state would benefit financially, he said, specifically mentioning that the University of Arkansas for Medical Science would see an annual net gain of about $28 million.
"The economic argument, if you don’t want to listen to any other argument, is a persuasive thing," he said. "How many of our communities could make it without their hospitals?"
Beebe, who wants to expand the program under the health care reform law, told a crowd of more than 300 health care industry officials that the Legislature will have the final say in next year’s regular session.
Republicans are making a push in the November general election to win majorities in the state House and Senate for the first time since Reconstruction.
Beebe said expects the general election to produce a slim majority either way, and he said Medicaid expansion won’t happen without bipartisan support because of the three-fourths vote required to appropriate funding.
"We’re not going to do this … if Republicans and Democrats don’t agree," the governor said. In that case, he said, "the other states will do what they want to do … money will be expended and we will be left out, and our hospitals will be left out, and our people will be left out and our tax papers will be left out."
Beebe then appeared to take a swipe at vocal Republican opponents of Medicaid expansion.
"We’ve got a bunch of people running around here now beating their chests, political, that need to keep their mouth shut, get the facts and then vote their conscience on what is in the best interest of their constituents and their people," he said.
The governor added that some opponents "are painting themselves into one heck of a corner right now because they’re either going to be put in a posture where they’re going to leave Arkansas out next January, or they are going to have to go backwards from what they’re telling the voters while they are running for office, and neither one of those things … seems to be a good option."
Rep. John Burris, R-Harrison, said any attempt by the governor to the use the Medicaid expansion debate for political purposes is "irresponsible."
"I don’t think anyone is beating their chest. We’re trying to take our time to get important information," he said, noting that the state faces up to a $400 million Medicaid shortfall at the end of the next fiscal year, and that there are many concerns about the management and sustainability of Medicaid.
"What we should be talking about is how we can come together in a bipartisan way and find a solution to keep providing the care for the people who are already promised care to, and that is the debate we should be having as we head into the session," Burris said.
The U.S. Supreme Court has upheld the federal health care law but said the federal government cannot coerce states into expanding their Medicaid programs by threatening to cut off Medicaid funding. That leaves it up to states to decide whether to expand the health care program for the poor, elderly and the disabled to include people earning up to 138 percent of the federal poverty level.
For those that do, the federal government will pick up the entire cost for three years, then gradually lower its contributions until the states eventually pay 10 percent.
State officials say the expansion would add about 250,000 people to the Medicaid program in Arkansas.
Beebe said he has received word from the federal government that Arkansas can opt out of the expansion if the state suffers a budget shortfall. The state is already paying the taxes, so opting out would mean Arkansas taxpayers’ money would go to other states that do expand their program, he said.
The governor urged delegates, many of them members of hospital auxillary programs, to go back home and tell candidates for the Legislature about the importance of Medicaid expansion to local hospitals.
"I’m not telling you who to vote for," he said. "You are smart enough to figure that out. But, whoever you vote for you ought to ask them about this issue."