LITTLE ROCK — After Gov. Mike Beebe announced his full support for expanding the state Medicaid program under the federal Affordable Care Act last week, a reporter asked the state’s Democratic chief executive if he saw the expansion as a good campaign issue for his party’s legislative candidates this fall.
"Yes, but you know, this doesn’t need to be politicized," Beebe said. "This is important on its merits."
Political insiders say there is zero chance expanding Medicaid won’t be a political football in the final weeks before the November general election as Republicans and Democrats battle for control of the Legislature.
"If Martians come down, then it won’t be a political issue," said Bill Vickery, a Little Rock-based Republican political consultant. "Barring a Martian entry into the state, it will be a political issue."
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 comply with a provision of the law calling for them to expand the program to include people earning up to 138 percent of the federal poverty level.
Beebe said last week that after receiving word from the federal government that Arkansas could opt out of the expansion in the event of a future budget crunch, he was ready to push for the expansion, which state officials say would add about 250,000 people to the Medicaid rolls. The federal government would cover the cost of the expansion for the first three years, after which the state would pay a portion that would gradually increase to a maximum of 10 percent.
Appropriating funds for expanding the government health care program for the poor, elderly and disabled would require a three-fourths vote in the Legislature, so the expansion could not happen without a consensus, including Republican support.
GOP lawmakers have fought implementation of any aspect of federal health care reform in Arkansas, and had asked Beebe to go slow in considering Medicaid expansion.
Beebe announced his position Tuesday. A day later, the state Republican Party slammed him for it.
"It’s clear Gov. Beebe’s agenda is to implement Obamacare and stick the state with a bill we can’t afford when he skips out of office in two years. That’s not how you govern responsibly and that’s not how you create a better future for Arkansas," state Republican Party spokeswoman Katherine Vasilos said in a release.
Vasilos said it was "yet another example of how Mike Beebe stands squarely with Barack Obama and his failed agenda."
GOP-produced mailers are already saturating portions of the state seeking to link Democratic candidates to Obama, and especially to his health care overhaul. The conservative group Americans for Prosperity also is planning a bus tour of the state this week with the theme, "Obama’s Failed Agenda."
Vickery said there are Republican candidates in other states searching for ways to link their campaigns to opposition to the health care overhaul. Beebe’s endorsement of the Medicaid expansion, although not an endorsement of the entire Affordable Care Act, gives Arkansas Republicans an avenue to do that, he said.
"The expansion is a direct linkage, and it is a killer issue for Republicans running in contested races," Vickery said. "It should not come as any surprise to anyone seeing mail pieces or commercials or anything that says a vote for a Democrat is a vote to implement Obamacare."
Obama is deeply unpopular in Arkansas. He lost by 20 percentage points to Republican John McCain in the state in 2008 and has received consistently low approval ratings from Arkansas voters.
But Debbie Wilhite, a Little Rock-based Democratic political consultant, said Democrats should not be on the defensive when it comes to expanding Medicaid.
"Candidates that I work with, I am urging them to be on the offensive with it," she said.
As one of the poorest states in the nation, Arkansas stands to benefit greatly from the mostly federally funded expansion, Wilhite said.
"We have elderly who are constantly choosing between their health care and food on the table — and food on the table for their grandchildren that they’ve taken in to raise," she said. "We have to as a society take care of the sick and elderly. This is a great opportunity for our state, and I don’t think we need to be defensive about it at all."
Candace Martin, spokeswoman for the state Democratic Party, said the expansion is a good issue for Democrats and a worthwhile issue for candidates to debate.
"By extending Medicaid, we can help up to 250,000 hard-working Arkansans and their families," she said. "If we deny these families in need (access)to health care through Medicaid, our doctors, hospitals and health care providers will not see billions of dollars. Instead, that money would go to other states. This is about putting Arkansans first, which is what we are focused on in this election."
Martin said Republicans risk alienating voters if they take a position that "would deny up to 250,000 working Arkansans access to a family doctor, and send our tax dollars to subsidize care in other states, like California or New York."
Vickery also said the issue is important and worth debating, but he said Democrats will not help their election chances by supporting anything that originated with Obama.
"Any ability to legitimately tie Democrats in Arkansas to President Obama is poison for the Democrats," he said.
Wilhite acknowledged that Democrats have their work cut out for them.
"Democrats have to do a much better job of educating people," she said. "The Republicans have people so scared about the future that they are very hesitant to listen to new facts about things that would help them."