Arkansas Senate OKs bill to keep Medicaid expansion

LITTLE ROCK (AP) — An effort to continue Arkansas' Medicaid expansion another year cleared a major hurdle in the state Legislature Tuesday, a day after the Trump administration said the state can impose a work requirement on the program.

Senators approved by a 27-2 vote the budget bill for Medicaid and the expansion program, which uses federal and state funds to purchase private insurance for low-income residents. The measure needed at least 27 votes in the 35-member Senate. A final vote on the bill is expected in the House on Wednesday.

More than 285,000 people are on Arkansas' hybrid program, which was created as an alternative to expanding traditional Medicaid under the federal health law.

The bill advanced a day after Medicaid officials approved Arkansas' request to require thousands on the program to work or volunteer to keep coverage. Arkansas is the third state allowed to impose work requirements on Medicaid participants. The Trump administration, which in January said it would allow states to impose work requirements on Medicaid recipients, has already approved proposals from Kentucky and Indiana.

"Obviously the work requirement was a significant factor in showing the reform that we're accomplishing, and I appreciate the Senate's leadership in passing this on the first vote," Republican Gov. Asa Hutchinson said in a statement after the vote.

Vacancies in the state Senate had created uncertainty about whether the expansion program had the three-fourths votes most budget measures need to

pass, but the requirement was seen as key to winning support. The deciding vote came from an opponent of the program who said he wanted to avoid leaving the Medicaid budget in limbo until a special session after the seats were filled.

"The work requirement was huge in getting me to the point that I could say, 'somebody needs to make this vote to keep us from having to keep the state in suspense for two months,'" Republican Sen. Alan Clark told reporters after the vote.

Critics of the program said the state can't afford to keep the expanded coverage.

"Medicaid is still on an unsustainable path," said Republican Sen. Bryan King, who voted against the measure.

Arkansas' work requirement will affect non-disabled, childless adults on the plan who are 19 to 49 years old. This year, the change will affect about 39,000 people from 30 to 49 years old, and over 30,000 more next year when it's rolled out for people ages 19 to 29, according to the state Department of Human Services.

People affected by the change will be required to work or participate in other activities such as volunteering or vocational training for 20 hours a week.

Arkansas' proposal will not affect people on its traditional Medicaid program, which covers more than 645,000 people statewide.

The budget also won support from Democrats who backed the measure despite concerns about the impact the work mandate will have on participants, especially in parts of the state where jobs may not be available.

"I would be more frustrated if we didn't have anything at all," Democratic Sen. Linda Chesterfield said.