UPDATE: Jump to the bottom for KUAR's interview with Conner Eldridge on the connection between the governor's Arkansas Works plan and the Affordable Care Act.
The latest salvo in Arkansas's U.S. Senate race has Democratic challenger Conner Eldridge calling on Republican incumbent John Boozman to "unequivocally" back federal funding for the governor's Arkansas Works plan.
The health insurance plan for over 250,000 low-income Arkansans is state-level legislation but most of its funding (100 percent until 2017, building up to 10 percent by 2021) for the newly eligible comes from the federal government. Each state can decide whether to participate in this expansion of Medicaid made possible by the Affordable Care Act.
Gov. Asa Hutchinson's Arkansas Works, which continues but changes a version of Medicaid expansion in place since 2014 known as the private option, passed in a special session of the state legislature last week with bi-partisan support. Its appropriation now faces a tougher test, a three-quarters vote threshold in the fiscal session that begins on Wednesday.
Senator Boozman has never said he doesn't support the Republican governor's plan but he has routinely voted to repeal the Affordable Care Act which contains the Medicaid expansion in place in Arkansas. In a statement on Monday Eldridge called on Boozman to back the funding that makes Arkansas Works possible.
"Senator Boozman, it is not too late for you to be a constructive part of this process," said Eldridge. "I urge you to unequivocally state your support for funding the Arkansas Works program in Arkansas. This is a critical week for the future of this program which is vital to the health care of hundreds of thousands of Arkansans."
The Eldridge campaign characterized a full repeal of the ACA as equivalent to terminating coverage for 267,000 Arkansans.
While Gov. Hutchinson and the majority of GOP state legislators back Arkansas Works they, like Boozman, also adamantly support repealing the Affordable Care Act. As an alternative to the Medicaid expansion provision of the ACA the governor and legislative leaders have previously called for the federal government to instead create a block grant allowing states to more freely spend federal Medicaid dollars. The governor has said if a bloc grant program is ever created, perhaps under a Republican president after the next election, it should maintain coverage for those now on his Arkansas Works plan.
In an interview before the March 1 primary, Sen. Boozman told KUAR he too supports a block grant and insuring additional people but he didn't commit to guaranteeing the funding levels that exist for the state's current Medicaid expansion program.
KAUFFMAN: Gov. Asa Hutchinson has said several times this week that the state must continue coverage that in some form provides health insurance for 200,000 low-income people - that were made newly eligible and funded by the Affordable Care Act. Let's say there's a new president and the repeal vote doesn't get vetoed, does the replacement have that money for Governor Hutchinson?
BOOZMAN: Certainly there are things going on with healthcare right now, things like portability. It shouldn't be that if you lose your job you lose your insurance, those are things that we need to keep in mind. I think we're going to have a situation where we have increased coverage. The two things that we needed as we started down the path of Obamacare, which I was very much opposed to, is that we need affordability and there were people that were uninsured. We needed to solve those problems. What we've put in place has driven costs up dramatically. I think as you get back into free market solutions you lower the cost and you are able to insure more people in a different way, much more cost effectively than we're doing now.
Probably you'd have a situation...nobody does a better job of handling the funds than the governors, I think you look at a situation where you block granted money to them. I've talked to a lot of governors both Democratic and Republican and what the governors want is flexibility. The needs in Arkansas regarding healthcare are much different than in Boston or Massachusetts or...
KAUFFMAN: But do they still want that money, the same amount [as in ACA]?
BOOZMAN: I don't think you can put it in those terms, what they want is the ability to help insure additional people. I think you do that by bloc granting, giving them the flexibility to make it such that they can use those dollars much, much more efficiently than they're doing now.
The full statement from the Eldridge campaign:
U.S. SENATE CANDIDATE ELDRIDGE COMMENDS GOV. HUTCHINSON AND STATE LAWMAKERS ON 'ARKANSAS WORKS' CRITICIZES SEN. BOOZMAN FOR SUPPORT OF FULL REPEAL AND TERMINATION OF HEALTH INSURANCE FOR 267,000 ARKANSANS
LITTLE ROCK – Former prosecutor and U.S. Attorney Conner Eldridge, who is running for the U.S. Senate, today commended Governor Asa Hutchinson and members of the Arkansas House and Senate, specifically House Speaker Jeremy Gillam, Senate President Pro Tempore Jonathan Dismang, House Minority Leader Michael John Gray and Senate Minority Leader Keith Ingram, for their leadership in continuing the Private Option's private health insurance coverage for 267,000 working Arkansans, now called Arkansas Works. Governor Hutchinson signed the bipartisan legislation into law last week.
“I again call on Senator Boozman to join me and the overwhelming number of state legislators from both parties in pledging to support Arkansas Works. Because both parties did the right thing by coming together and putting people over politics, more than 250,000 working Arkansans will continue to have affordable private health insurance,” said Eldridge. “Senator Boozman’s comments, in which he said he has 'no qualms' about ending private health insurance for over a quarter of a million people, show how out of touch he has become with working families in Arkansas who are struggling to make ends meet. We desperately need leadership that is willing to put the people of Arkansas first, which is why I am committed to being a strong, new voice and a fierce advocate for all Arkansans.”
There are currently over 250,000 Arkansans enrolled in the Private Option, now called Arkansas Works, which has led to Arkansas’s uninsured rate falling from 22.5 to 9.1 percent since 2013. "Senator Boozman, it is not too late for you to be a constructive part of this process," said Eldridge. "I urge you to unequivocally state your support for funding the Arkansas Works program in Arkansas. This is a critical week for the future of this program, which is vital to the health care of hundreds of thousands of Arkansans."
UPDATE: Eldridge talked to KUAR Monday afternoon about the connection between the Affordable Care Act and the governor's Arkansas Works plan.
Arkansas Works is headed into the fiscal session of the state legislature this week with a tough vote threshold. You’ve made the connection between the Arkansas Works plan at the state level and the Affordable Care Act in Congress. Why is a repeal for the ACA equal to a termination of coverage for around 250,000 in the governor’s Medicaid plan?
It would end the funding stream that provides for health care coverage. Through the leadership of Governor Beebe and now Governor Hutchinson along with a bi-partisan group in the legislature we first had the private option and hopefully after this week we’ll have the continuation of the private option via Arkansas Works.
There’s obviously a direct connection between them
You’ve said before that a full repeal of the Affordable Care Act is a distraction but that there are flaws that need to be fixed. Is Medicaid expansion not a flaw, but something you think generally works?
Certainly with the waivers that Arkansas has been provided and sought, that’s afforded the creativity that has permitted the private option and permitted expansion in a way that works for Arkansas. It has resulted in coverage for a large number of working families and people that didn’t have health insurance before.
There are a lot of things in the Affordable Care Act that do need to be fixed and there are tremendous problems in the healthcare area that Arkansans are facing every day but I think you’ve got to find a way to continue the coverage that we now have.
Senator Bookman as well as Governor Asa Hutchinson say they do want to get rid of Medicaid expansion as set up under the ACA and instead they want many of those people to be covered under a block grant.
I think the real issue is the funding stream that’s been provided and to repeal the Affordable Care Act is a vote to get rid of that. In the over 50 Senator Boozman has voted to repeal the ACA only very recently did he suggest any conceivable alternative.
While the term block grant does imply some continuation of that funding his comments have not been very clear about any of that. Really he’s just voted for repeal and in one instance said that he had ‘no qualms’ about kicking those people off their health insurance I’ve got a real problem with that.
I think it’s an essential thing we’ve got to provide and without it families would suffer and many rural hospitals, including those ten or so that are considered distressed in Arkansas would in all likelihood fall by the wayside.
My position is very clear. I would not vote to repeal the Affordable Care Act. I support the private option. I support Arkansas Works. I call on the legislature, and Senator Boozman for that matter, to support the funding for the program this week and I honestly don’t understand any position to the contrary.
It’s hard to ask any question about a block grant because it is a very amorphous funding solution. There just aren’t a lot of concrete answers as to what the block grant would look like. But in general do you support flexibility that would allow governors to have a block grant, assuming some standards stay in place? Do you think that a block grant is a good alternative to Medicaid expansion in the future or is the current system good enough?
I think that states need to have flexibility, that’s the real issue. In this situation Arkansas was given flexibility under Governor Beebe. The original private option required seeking a waiver from the federal government. I think Arkansas has shown that if you give states flexibility we produce innovate solutions that deliver results for people in the state.
In order to have that you’ve got to be able to get into the weeds of this and to fight for it and to advocate for it and Senator Boozman has not done that. He’s just sort of sat idly by and waited to repeal. I still see no clear proposal from him. We need leadership here and that means clearly saying where you stand and going out and fighting for it.
KUAR hopes to have an interview with Sen. Boozman later this week.