On Wednesday, the state House of Representatives voted 79-15* to approve the budget for Arkansas Works, the Medicaid-funded program that provides health insurance to 285,000 Arkansans.

Senate Bill 30, which funds the Arkansas Department of Human Services’ Division of Medical Services for the 2019 fiscal year, now heads to the governor’s desk. It passed the Senate yesterday with no votes to spare, 27-2. In Arkansas, appropriation bills require a three-fourths majority in both the 35-member Senate and the 100-member House for passage.


Since the Medicaid expansion was first approved by the legislature in 2013, the program has divided the Arkansas GOP. Each year has brought a return of the same battle, in which a minority of Republican legislators threatened to block the DHS appropriation bill — and with it, the entire state Medicaid budget, including services for children, the elderly and the disabled. Each year has seen the standoff resolved in the same way: After aggressive lobbying by interest groups, the governor and legislative leadership eventually convince a few holdouts to change their votes to a “yes.”

In the 2018 fiscal session, three vacancies in the Senate made approval of Arkansas Works seem even more daunting. Some expected that a final vote would have to wait until after those seats were filled by special elections in May. But unlike previous years, the drama failed to materialize.


On Tuesday, two Republican senators who opposed Arkansas Works for years decided to vote for SB 30. After about an hour of discussion, the bill passed on the first vote. On Wednesday, the House passed SB 30 with no discussion at all. Although 15 members voted “no” and another five either did not vote or voted “present,” no representative rose to speak against the bill. (The House also has one vacant seat.)

Governor Hutchinson welcomed the development.


“The early prediction was that the General Assembly would not pass the DHS appropriation and Arkansas Works,” he said in a statement Wednesday afternoon. “I am pleased that the Senate and the House disproved the popular opinion and passed the bill. The fact that we passed it on the first vote in both houses shows a spirit of cooperation between the branches. The approval demonstrates that in Arkansas, people still listen to each other and work together for solutions.”

On Monday, the Trump administration announced approval of a waiver requested by Hutchinson that will allow the state to impose a work requirement on Arkansas Works beneficiaries. Arkansas Works recipients ages 19-49 will be required to prove they are working for at least 80 hours per month unless they meet one of several exemptions, such as providing care to a dependent. Those who do not comply may lose coverage.

Asked why Arkansas Works passed so easily this session, the governor pointed both to the work requirement and other efforts to more tightly enforce eligibility requirements within DHS.

“The main thing [legislators] wanted to be able to see were our continued efforts at reform. … The success that we had last year in improving the systems gave them confidence,” he told reporters after the House vote. Hutchinson said the work requirement also “gave them a higher level of confidence that we’re going the right direction.”


But Rep. Michael John Gray (D-Augusta), who is also the chair of the state Democratic Party, disagreed, instead citing the program’s net positive impact on the Arkansas budget.

“I don’t think the work requirement got this thing passed,” Gray said. “I really think they’re seeing what’s happening in Kansas and Oklahoma where these major tax cuts have taken place for political gain, and they haven’t had Medicaid dollars to shore it up.

“The governor’s entire budget is predicated on expansion dollars,” Gray said. “If you’re a rural advocate, you know that you’re not going to have hospitals and doctors and adequate medical care without expansion dollars. So we’re seeing a real transition from getting out there and campaigning on the tailwind of [being] anti-Obamacare, to getting down here and having to do business and realizing to take care of the people we represent, sometimes politics have to be put aside. Luckily, today, finally, six years later, it looks like it was put aside.”

Arkansas Works is projected to cost more than $2 billion in the upcoming 2019 fiscal year, with the vast majority coming from federal funds. Arkansas’s share is expected to be about $136 million. Under the Medicaid expansion, Arkansas bears 6 percent of the cost of the program in 2018, rising to 7 percent in 2019 and maxing out at 10 percent in 2020.

*A previous version of this story incorrectly reported the vote count.

This reporting is courtesy of the Arkansas Nonprofit News Network, an independent, nonpartisan news project dedicated to producing journalism that matters to Arkansans. Find out more at arknews.org.