LITTLE ROCK — Arkansas Gov. Mike Beebe said Wednesday he’s still inclined to go forward with an expansion of Medicaid under the federal health care law, but that the decision will ultimately come down to a super-majority vote in the Legislature next year.
Beebe told reporters he was encouraged by estimates released Tuesday by the Department of Human Services that said expanding Medicaid eligibility would result in a $372 million net savings for the state over the next several years. The department’s estimate factored in savings that the state would see in benefits from the federal health care law.
The U.S. Supreme Court last month upheld the health care law, but justices said the federal government could not take away states’ existing federal Medicaid dollars if states refused to widen eligibility.
Since appropriating the money requires a three-fourths vote in the Legislature, Beebe said lawmakers will have a say on whether to expand the program.
"I’d say the final decision is a joint decision," Beebe said. "If I didn’t want to do it, if I thought it was not in our state’s interest and chose not to pursue it, I think that’s the final decision. If I think it’s in our state’s best interest to pursue it, then it’s going to take a cooperative effort and at least three-fourths of the Legislature is going to have to agree to appropriate the money."
Under the health care law, the federal government agreed to pay the full tab for the Medicaid expansion when it begins in 2014. After three years, states must pay a gradually increasing share that tops out at 10 percent of the cost. Human Services officials said the net cost to the state would reach about $4 million in 2021.
Beebe has said he wants answers from the federal government on how much flexibility Arkansas would have and whether the state would be locked in to the expansion even if it faces financial problems later.
The DHS has said expanding Medicaid’s eligibility would add 250,000 Arkansas residents to the program.
Republicans in the majority-Democrat Legislature have said they’re opposed to the expansion and have expressed skepticism about the DHS estimates. Beebe said whether he can get a three-fourths vote isn’t factoring into his decision.
"I don’t think I’m being naive. I think more than three-fourths of that general assembly will do what they honestly think is right for the people of Arkansas," Beebe said. "If the facts support both economic and humanitarian reasons for accepting this, I think more than three-fourths will."