The House today passed the Medical Services appropriation, which includes the funding for “Arkansas Works,” the governor’s plan to continue the private option Medicaid expansion.

The count: 76 Yea, 13 Nay, 11 present (same as a no), hitting the supermajority. Once again, all Democrats voted Aye. Those voting against it were a rump group of Republicans willing to block the entire Medicaid program in order to achieve their goal of ending health insurance coverage for 267,000 Arkansans.

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The count was actually 77. Rep. Karilyn Brown said that she voted “present” accidentally but meant to vote Yes. While they will not change the official vote count, she will get it changed in the record. 

If you’ve been reading the blog this week, you know the game here: the appropriation includes a dummy amendment that says “Arkansas Works” will end. However, the governor has promised to line-item veto that amendment and allow the Medicaid expansion to continue. He will do so this afternoon, signing the appropriation into law (there will be no ceremony). There may be a call for a veto override, but that’s irrelevant since the overwhelming majority of the legislature supports “Arkansas Works.”

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There’s been a fair amount of scuttlebutt at the Capitol this week about who originally thought of the idea to use the line-item-veto scheme. Like all origin stories, the details are murky. The concept had been kicked around in backrooms for years; one former lawmaker told me that it had been briefly considered more than a decade ago. 

In terms of using it to resolve this year’s Medicaid budget impasse, I think the truth is that there was ongoing discussion and brainstorming among a number of key figures in the legislature and the governor’s office. 

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A scattering of legislative and executive staffers were involved in thinking this thing through over the last several weeks and Sen. Larry Teague, the chair of the Joint Budget Committee (a Democrat) and Duncan Baird, Hutchinson’s State Budget Administrator, were reportedly in the mix. Gov. Asa Hutchinson himself was reportedly closely involved in developing the strategy. A few other lawmakers and stakeholders were also involved, but the number of people who knew about the strategy was quite small until last week. 
 
But curious cats at the Capitol want to know who first came up with the idea! I doubt we’ll ever get definitive confirmation. Among the various sources I’ve spoken with, I heard a few different names, but the answer I heard the most often as the one who got the ball rolling on this strategy to resolve the Medicaid impasse: Teague. 

*This post has been updated to more clearly reflect the development of the line-item plan. 

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

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