With the special session on Medicaid expansion all but upon us Democrats are continuing to show signs that their support is not to be taken for granted by the Republican governor. Democratic Party of Arkansas Chair Vincent Insalaco released a statement today making the case for Democratic leverage.
"Democrats will not stand for any change to the Private Option that would make it harder for thousands of Arkansans to keep their health insurance. Clearly, Governor Asa Hutchinson has no Republican majority when it comes to continuing the Private Option. He will need the help of some Democrats."
Insalaco didn't say he opposed any specific provision of Hutchinson's Arkansas Works plan which is subject to approval from federal officials overseeing the disbursement of Medicaid funds and state-level adaptation of the program. Arkansas uses expanded funds and eligibility created under the Affordable Care Act to purchase private insurance for 250,000 low-income residents. Rather, the party chair outlined a number of the ill effects he envisions if the legislature fails to re-authorize Medicaid expansion.
Medicaid expansion, now known as the private option and perhaps soon known as Arkansas Works, has had several close encounters with the most conservative wing of the Republican-controlled legislature since its 2013 inception. Every time it has passed because Democrats and about half of the Republican caucus joined forces. Past votes on appropriations for the private option have required a 3/4 vote from each chamber.
Hutchinson has called the term "private option" politically toxic and in 2015 backed legislation that ends the program at the end of this year barring further legislative action. That legislation also set up a task force to look at continuing coverage to the expanded Medicaid population. Hutchinson's continuation is known as Arkansas Works.
Critics have derided the move as little more than a re-branding effort that includes a few conservative changes built around concepts such as personal responsibility and program integrity, including some small premiums and work training referrals. The basic structure of the private option, taking funds from the ACA to purchase private insurance (rather than not accepting Medicaid expansion or using the traditional Medicaid program for coverage), is still in place.
Insalaco's release had the name "Arkansas Works" just once. He used the term "private option" 18 times. The implication from the Demoratic Party is clear, Hutchinson is not creating a new program but rather embracing a concept backed by his Democratic predecessor Mike Beebe.
"He has come to agree with Democrats who, since 2013, have consistently said 'Losing the Private Option would leave a huge hole in Arkansas's budget and cripple many rural hospitals.'"