In a letter to House Speaker Jeremy Gillam, the Democratic Caucus today requested that no appropriations be taken up until the legislature moves forward with the Medical Services appropriation. 

That is the Medicaid budget within the Department of Human Services that is expected to be blocked by a rump group of Tea Party Republicans who oppose the private option Medicaid expansion.


“It would be a dereliction of our duty as legislators to vote on any appropriation until we have a final decision on SB 121 [the Medicaid budget] and know its impact on our entire state budget,”states the letter, signed by Minority Leader Michael John Gray (D-Augusta) and cc’d to the governor and the leadership in the senate. 

The governor’s plan to continue the private option, re-named “Arkansas Works,” easily passed by large bipartisan majorities last week. However, opponents of “Arkansas Works” have said that they will refuse to approve the Medical Services appropriation — which includes the funding for  both “Arkansas Works” as well as the entire Medicaid program (not just the expansion population, in other words, but the elderly in nursing homes, the disabled, children on ARKids, and many more vulnerable populations) — unless the private option ends. Under the prevailing understanding of the law, the Medical Services appropriation must be approved by 75 percent of both chambers. Just nine senators or twenty-six House members could block it, and the aginners appear to at least have enough for a blockade in the Senate. They say that unless “Arkansas Works” is stripped out, they will shut down the Medicaid program.


(Note: most of the relevant funds are federal money, not state, but the legislature could block those funds from being appropriated.)

The Democrats, a minority, but a bigger one than the rump group of Tea Party lawmakers, are going to do everything in their power to keep the Medicaid expansion in place. They could play hardball and decline to approve other appropriations until the Medicaid expansion is re-authorized. However, Gray said that the letter should not be taken as a threat to block appropriations unless the Democrats get their way on Medicaid expansion. “In the letter to the Speaker, we by no means made a demand that it pass,” Gray told me. “That would be doing what the gang on the other end is doing. We’ll continue to do what we always do — take a reasonable look at things. I think you saw in the Eighty-ninth General Assembly, ultimately there were some changes made in the appropriation that the majority of Democrats were not happy with but they understood that at the end of the day you make the reasonable, responsible decision.” That’s not to say that Democrats would blindly pass any appropriation, Gray said, but he said that they had no intention of making threats.  


Instead, Gray said, the Democrats made their request to wait on other appropriations until the Medicaid question is resolved because of practical considerations. If “Arkansas Works” doesn’t move forward, it leaves a hole in the budget, to the tune of $140 to $200 million. Gillam on Monday released an alternative budget with 3-to-5 percent cuts across the board, leaving all sorts of questions about just how the legislature would proceed if lawmakers voluntarily choose to thumb their noses at a massive infusion of federal funds. Gray said that it would be “irresponsible” to pass a series of appropriations that then might have to be significantly altered if “Arkansas Works” was killed and lawmakers were left scrambling to fill a budget hole.   

“[I]f the current proposed SB 121 were to fail there would be many and significant changes to the budget,” Gray states in his letter. “With the release of the alternative budget we think it would be prudent to first come to a final decision on SB 121 so members can be clear on which budget they would consider. The potential $200 million budget shortfall would give every legislator reason to consider the effects of these changes and how they would impact the people of Arkansas.”

Said Gray: “Why are we sitting down here spending everybody’s money to vote on a bunch of appropriations that may all have to be changed?” 

Gillam said that he had read the letter and spoken with Gray. “I’m going to take it under consideration. Any time you’ve got that large of group of members that is asking something of me, I’m going to weigh it and look at it.” Gillams said that his initial plan was to proceed with other appropriations even if, as expected, the Medical Services appropriation stalls. “The plan I had been going along with was that we would continue to take care of business and move forward,” he said. “But in light of this request, I am going to back up, take a look at this, and talk to the members.” 


While the letter is framed as a request, I asked Gillam whether he was worried about Democrats simply declining to approve appropriations until the Medical Services appropriation question was resolved one way or the other. 

“We don’t have that kind of dynamic in this chamber,” Gillam said. “We have great working relationships with both of the caucuses. I think that’s where they’re saying: ‘hey, let’s talk about it and look at it.’ And we’re going to do that.”  

I asked Gray whether Democrats would hold up the train until the Medicaid budget is actually resolved. “I think you can take our letter as: Mr. Speaker, we don’t want to get to that point but we are prepared to not vote on anything before we vote on that appropriation.”

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