The Senate Insurance and Commerce Committee today passed the “Arkansas Works” bill, the governor’s plan to continue the Medicaid expansion private option. The bill passed on a voice vote. (Update: a twin bill also passed out of House Committee, see below.)

Here is the legislation


The House committee will meet shortly to pass an identical bill. The twin bills will work their way through the process, with final passage expected on Friday.

This is all a bit of a formality. The challenge for Medicaid expansion will come next week in the fiscal session. A rump group of Tea Party Republicans is determined to end the health insurance program for 275,000 low-income Arkansans; in order to do so, they are threatening to block the entire Medicaid budget (including funding for the elderly in nursing homes, children in ARKids, and the severely disabled). The Medicaid appropriation demands 75 percent approval in both houses, expected to be a tough hurdle.  


The bill was presented by Sen. Jim Hendren, who did a thorough job of running through the massive financial impact that Medicaid expansion has on the state. I’ll have more on this later, but in short: the Arkansas health care system, hospitals, and state budget would lose billions of dollars if legislators kill the Medicaid expansion. Hendren made a detailed, powerful case for re-authorizing the policy — particularly notable since Hendren was a strong opponent of the policy in 2013 and 2014. 

David Ray, state director of Americans for Prosperity Arkansas, spoke against the bill. Ray complained that Arkansas Works would continue the Medicaid expansion via Obamacare funds. He hit the usual talking points. Ray also argued that taking health insurance away from citizens in Arkansas would lead to more of them getting a job. 


Dan Rahn, chancellor at the University of Arkansas Medical Sciences, spoke for the bill. Rahn said that if the legislature kills the Medicaid expansion, UAMS would face a $65 million bigger hole in its budget, leading to reducing care, reducing trauma services, and other vital services, as well as massive cuts to the academic programs.


The House Insurance and Commerce Committee passed its own version of the same bill on a voice vote. The existence of two bills is a procedural maneuver to move the legislation quickly through the process; it’s essentially one piece of legislation. The bills will now go the full Senate and the full House, respectively. They will then flip and go the other chamber for final passage on Friday.

As noted above, “Arkansas Works” is expected to pass easily, but faces a challenge next week in the fiscal session. Even if the law passes with a healthy majority, a small minority of Tea Party Republicans say that they will shut down the government rather than let the policy continue.

Rep. Charlie Collins, one of the co-sponsors of the “Arkansas Works” bill, presented the bill. He went through an oldie-but-goodie list of all of the predictions of disaster that private option opponents made when the policy was first enacted. All of those objections proved to be baloney, Collins pointed out. “This has been a good deal for Arkansas taxpayers and all Arkansans,” Collins said.


Support for special health care reporting made possible by the Arkansas Public Policy Panel.