LITTLE ROCK — Republican state lawmakers differed Tuesday in their reaction to the Obama administration ruling out phased-in or partial expansion of Medicaid — some said it hurt chances of expansion in Arkansas, others said compromise is still possible.
The White House announced this week that gradual or partial Medicaid expansion is not an option for states under the federal Affordable Care Act. The U.S. Supreme Court has said any expansion must be optional for states under the law.
Gov. Mike Beebe favors expanding the government health program for the poor, elderly and disabled to cover up to 250,000 additional Arkansans. Republican legislators have been cool to the proposal, and GOP lawmakers will control both chambers of the state Legislature next for the first time since the end of the Civil War.
Sen. Johnny Key, R-Mountain Home, said Tuesday, "It just got a lot harder to get where the governor’s asking us to go."
Key said the announcement from the Obama administration signals that "obviously from their side compromise is not a goal."
The ACA proposes that states expand their Medicaid programs to include people earning up to 138 percent of the poverty level, which in Arkansas is estimated to add 250,000 people to the Medicaid rolls. The federal government would pay the entire cost of the expansion for the first three years, after which the state’s share would gradually increase and eventually max out at 10 percent.
Some governors had suggested expanding their Medicaid programs to less than 138 percent of the poverty level or phasing in the expansion. The Obama administration said Monday the law does not provide for those options.
Rep. Andrea Lea, R-Russellville, said Tuesday she was more confused after the announcement than she was before.
"That’s different from what we had just been told about a month ago. What I remember the governor saying is that the letter he received from them said there was wiggle room," she said.
Matt DeCample, a spokesman for Beebe, said the governor did not tell legislators that a partial expansion was a definite option.
"I think what we’ve said is it something we’d be able to discuss as long as the federal government was agreeable to it," he said.
DeCample said the announcement Monday "takes an option off the table, obviously, when we’re in discussions with legislators in the coming months."
Sen. Michael Lamoureux, R-Russellville, the incoming Senate president pro tem, said he has not given up on the possibility of a compromise.
"If we let the fact that the federal government gives us a new set of rules once a week dictate how we try to set our Medicaid policy, then I think we’ll never have a Medicaid policy," he said. "My first instinct after hearing their announcement is to essentially set it aside and see if we can work in a bipartisan manner to come up with what we think our law should look like, and doing that in conjunction with the governor, and then seeing if he’s able to sell that to the appropriate federal officials."
Lamoureux said that if Republicans were to agree to an expansion they would want to see accompanying changes to the structure of the Medicaid program. Changes that have been suggested include cutting waste, fraud and abuse, creating a system of co-payments and requiring drug-testing of Medicaid recipients.
Beebe has requested a federal waiver that would permit structural changes to the Medicaid program.
Rep. Davy Carter, R-Cabot, the House speaker-designate, said he was disappointed by the announcement, but "I’m just glad that we know whether it is or it isn’t (an option), and we can narrow down what choices we have."
Carter said a compromise may still be possible, but the likelihood "is less now than what it was."
"Any time the states have more flexibility, that facilitates more of a potential of coming to some agreement. Basically we have no flexibility," he said.