Thoughts From The Arkansas Senate On The Medicaid Line Item Veto Workaround

Apr 18, 2016

The floor of the Arkansas Senate.
Credit Arkansas.gov

Backers of Arkansas’s Medicaid expansion plan are expected to try again this week to overcome the resistance of a minority of Republican lawmakers and pass a budget bill. 

Proponents hope to continue the plan’s funding by paradoxically crafting an amendment to remove it from the overall Medicaid budget. Once passed, the governor promises to issue a line item veto which would effectively reinstate funding for the expansion plan component. 

Republican Bart Hester and Democrat Keith Ingram in the state Senate spoke with KUAR about the status of legislation. Hester has been one of the opposition's leaders but he along with two others have agreed to vote for the amendment removing funding, knowing that it's part of the governor's plan to actually continue the program. Democratic Minority Leader Keith Ingram is still undecided on the tactic but says his caucus is receiving assuring messages from the governor.

State Sen. Bart Hester (R-Cave Springs).
Credit Arkansas Times

We’ve been saying for a while now that the “big day” is coming for Medicaid expansion in the Arkansas Legislature but this week really might be it. State Senator Bart Hester of Cave Springs and Benton County joins me on the line. Thanks for your time.

I’ll try to make this short and easy, but it’s not, so listeners listen closely. Tomorrow or Wednesday the advocates of the governor’s Arkansas Works plan are likely introducing an amendment to remove its funding from the state’s overall Medicaid budget bill. But, in a very planned and publicly telegraphed twist, Governor Asa Hutchinson says he will use a line-item veto, to undo the amendment, essentially re-instating funding. This is all meant to circumvent Senator Bart Hester, and 9 other Republicans, blocking by two votes the three-fourths majority needed to pass Medicaid’s budget.

Senator Hester, I bet it’s been a long weekend. Who have you been hearing from?

I’m hearing from a lot of folks thanking me for holding our ground on this Medicaid expansion. I’m also hearing form people that are concerned about things that aren’t involved in the argument like Heifer funding and things for children with disabilities – all things that aren’t part of the expansion argument. But I’m hearing a lot from both sides.

What do you think of this line item veto route? It allows you to vote for an amendment removing Medicaid expansion funds, which is your ultimate goal. But you know, it’s in effect a path toward keeping funding, once the governor issues his line item veto. Do you know how will you vote on it?

I intend to vote for the bill that I’ve asked for. Ultimately I can’t control whether the governor’s going to veto or not. I voted for many bills that I knew Governor Beebe was going to veto. I’m not the governor and I can’t control his veto power.

Knowing that he’s doing that on purpose, just so he can veto it later, do you think it would be better to not vote on the amendment and wait until some other Republicans come around to your side?

You’d have to get 18 more and the governor to change their mind to my way of thinking and that’s just on the Senate side. At the end of the day, I would fight this thing to the very end if I could see a path to stopping this expansion population. It’s not that I oppose the population, I want them to have insurance and to do well but we don’t have $150 million to pay for it.

When the fiscal session began, you must have known the majority of the Republicans as well as every Democrat would vote to fund the governor’s plan – which is mostly paid for by the Affordable Care Act. What was your end game? Did you have higher hopes?

I had hopes the governor would concede on some points. Ultimately that has proven to not be the case. We worked down a lot of rabbit trails to try to get some concession and to this point hae not been successful. That could all change tonight. I’ve been actively involved witht the governor’s office today, still working on what I consider some very minor but reasonable changes.

Can you share those?

One of the things would be asset testing. Regardless of what side you’re on, if there’s somebody that’s a millionaire sitting there and doesn’t have a job they shouldn’t be getting free health insurance. I think you’ll find that with a lot of people that maybe sold a small business, earned some money, but maybe they’re seven or eight years away from Medicare but maybe they’re sitting on assets worth a ton of money.

The governor says he didn’t put that on there because they federal government would just say no right off the bat.

What I’d like to do is give the governor the right to asset test, the authority to do it if the federal government changes their mind. I think there’s some positions that say the federal government can’t refuse it. I just think it’s a very reasonable request to give the governor authority to asset test should he get approval from the federal government.

What’s the lesson of all of this? Does it have any implications about the three-fourths vote requirement or future Medicaid stands?

I don’t know, I think at the end of the day people expect us to fight to the very end and fight as hard as we can for the things that we said we’re going to fight for. I’m going to continue to do that, it doesn’t deter me one bit. Things in politics change daily and hourly and you just want to hold the line as long as possible on this.

If this wasn’t mixed up with other Medicaid funding there would be no doubt in my mind we would hold this to the very end. I think it’s unfair to bring in groups of other people like the disabled and drag them into the argument over able bodied adults. They certainly could be separated but I don’t have the majority on my side.

Are you worried that your stand here, against the Medicaid budget and the governor’s office, will come at a cost to your legislative career? You passed some prominent bills last session. There’s all sorts of tactics, the carrot and the stick approach, there seems to be a lot of hostility within your caucus.

I can’t worry about what’s going to happen next year or the next year. I’m going to have this position through 2020 and I’m going to fight every day for what I believe is right. You can argue without being hateful to your colleagues or disrespectful. You’ll have a hard time finding many legislators that say I’m not respectful of them and a friend of theirs and I really work on that. A few days after this is over I don’t think there will be any different opinion of me moving forward. I’m certainly not surprising any of my colleagues with my position on this.

Democratic Senate Minority Leader Keith Ingram (D-West Memphis).
Credit Jacob Kauffman / KUAR

The Ingram interview:

It seems like the initial hesitation from many Democrats over the line item veto route – to keep Medicaid expansion – was about not having enough to time last Thursday to think about it before a committee vote was held. What was the four day weekend like and are you happy with how inclusive the governor’s office is being?

The governor came to present his thoughts to us last week. I think probably we would have all been better served if we hadn’t rushed that vote Thursday and had taken a deep breath and gone home and thought about it.

The governor has said today that the bill is thoroughly vetted and in his estimation does not have any constitutional prohibitions. Certainly we didn’t have that information on Thursday and I think that was some of the concern.

It was the second day of the session and we thought ‘let’s make sure we get this right.’ Obviously I would prefer it if they could bring two of the 10 (Republicans opposing the plan in the Senate) over. It would make it a lot cleaner piece of legislation than having to go through this circuitous route that we’re pursuing.

What about the argument by some Democrats, like Senator Joyce Elliott and Linda Chesterfield of Little Rock, that supporting the amendment is asking Democrats to swallow their pride while the 10 Republicans get to have their show vote?

I don’t think of it as much as swallowing you pride as much as it is being the adults in the room. If you look at the controversy over the RFRA (Religious Freedom and Restoration Act) law last year it was Democrats that made key votes to stop what’s happening in Mississippi now from happening in Arkansas.

There is some thought that the Republican Party should be able to take care of its own in this matter, especially when they control both houses and the governor’s office. The governor feels that they’ve exhausted all possibility with this 10. If that’s the case, then I guess we’ll have to go to a plan B or plan C.

At some level the ends justify the means. We can’t kick 267,000 people off of the private option as well as the rest of the DHS budget. We’ve got to find a way to make it all work.

Since the governor has said policy changes to Arkansas Works are off the table. What is the way for the governor to convince two of those 10? Should he offer something to them or threaten them, what’s the method?

The governor has many tools in his tool chest to work with legislators. 75 percent is an extremely high bar, a supermajority is. Other governors have met it, unfortunately this governor within his own party is having tremendous difficulty.

I think this is quite honestly a battle of ideology. It is not a battle of ideas. When you’re up against an ideologue there’s no compromise and that’s what happening in Washington. It’s ideological instead of coming to common ground for the greater good. You have seen the extreme of the Republican Party bring Washington politics to Arkansas.

I think I know how you’ll vote tomorrow. But how will you vote?

I’m going to listen to what all our folks have to say and we’ll make the decision after that as to what we think is the best policy to follow. We should caucus either tonight or tomorrow morning.