Medicaid expansion funding clears Senate

Work mandate helped swing last 2 votes

The Arkansas Senate on Tuesday narrowly approved a measure authorizing the use of $8.2 billion in state and federal funds for the state’s Division of Medical Services, including spending authority for the state’s Medicaid expansion, in the coming fiscal year.

With the Senate having 35 seats — three of which are currently vacant, the votes of Republican Sens. Alan Clark of Lonsdale and Terry Rice of Waldron for Senate Bill 30 helped supporters of Arkansas Works — which insures poor people — get the required 27 votes for its approval, with two against it. SB30 is the appropriation for the Division of Medical Services for fiscal 2019, which starts July 1.

It’s been difficult to get the three-fourths vote required in the Senate and House virtually every year since the program was created because the program has deeply divided Republicans.

After 26 senators voted for the measure, Clark gave a thumbs-up to cast the 27th vote. He told fellow senators

he would vote for the appropriation “if we are one vote short.” The measure now moves to the House.

The Senate’s approval of SB30 came after more than an hour of sometimes emotional debate.

The chamber initially voted 5-17 to defeat a motion by Sen. Bryan King, R-Green Forest — a Medicaid expansion foe — to postpone action indefinitely on the bill until a special session is called by Gov. Asa Hutchinson later this fiscal year.

Senate President Pro Tempore Jonathan Dismang, R-Searcy, acknowledged, “I didn’t know what to anticipate prior to the roll being called.”

Dismang, who is one of three legislative architects of the Medicaid expansion authorized in 2013, said he’s relieved the appropriation cleared the Senate because “I think this helps us move forward, get ourselves closer to getting out of this session and wrapping things up” by Friday.

Wednesday is the 24th day of the fiscal session. The four previous fiscal sessions have ranged from 25 days in 2010 to 38 days in 2014.

The votes of Clark and Rice for the appropriation were a surprise because they are opponents of the state’s version of Medicaid expansion, which covers about 285,000 low-income Arkansans.

The Department of Human Services has projected the Arkansas Works program will cost about $135 million in state funds and about $1.95 billion in federal funds in fiscal 2018. The program’s income cutoff is at 138 percent of the poverty level, which is $16,753 for an individual or $34,838 for a family of four.

But Clark said he decided Tuesday to vote for the Division of Medical Services appropriation because “there is no sense in us coming back in two months [after special elections to fill two vacancies] and doing what we could have done today just to be stubborn.”

Two of the vacant seats — formerly held by Sen. Eddie Joe Williams, R-Cabot, and the late Sen. Greg Standridge, R-Russellville — will be filled in special elections May 22,