LITTLE ROCK — Arkansas Gov. Asa Hutchinson said Friday that his proposal to shift some Medicaid services to private companies broadens the debate about the program’s future beyond the hybrid expansion he has been urging lawmakers to save.
The Republican governor called his managed care and expansion proposals "historic," a day after lawmakers got their first look at legislation outlining his plans ahead of a special session planned April 6 on both issues. "We’ve broadened the debate simply from the one small slice of the pie chart that is impacted by the expanded Medicaid population and we’ve put the reform in the entire pie of Medicaid," Hutchinson told reporters at the state Capitol.
Hutchinson has proposed having the state contract with private companies to manage the state’s Medicaid services for the developmentally disabled and mentally ill. Hutchinson said some of the $1.4 billion in savings projected from the managed care proposal would be used to reduce the state’s waiting list for home and community-based services for the developmentally disabled.
"It is a realistic plan to create savings, and the savings can be used to reduce that waiting list population and creates a trust fund to accomplish that," he said.
The managed care proposal faces resistance, especially from Democrats who have historically backed the state’s hybrid expansion. Top Democrats in both chambers say they’re encouraged the managed care and expansion proposals will be considered separately.
Senate Minority Leader Keith Ingram said he’d prefer the competing proposal offered by managed care opponents that calls for the state to contract with a private company to coordinate some services. Unlike the managed care proposal, the state would still pay health providers directly under this plan.
"I’m just uncomfortable with making this big of a move when so many states have had mixed results," said Ingram, a Democrat from West Memphis.
Hutchinson also faces a split among Republicans on his plan to keep the state’s hybrid expansion, which uses federal funds to purchase private insurance for the poor. The program was approved in 2013 as an alternative to expanding Medicaid under the federal health law.
Hutchinson has proposed adding new restrictions, including a requirement that beneficiaries making at least 100 percent of the federal poverty level pay premiums.
Hutchinson said he’s focusing now on getting the simple majority needed to pass the legislation outlining the changes in next month’s special session. Final approval for keeping the reworked program will mean passing the Medicaid budget bill, which will require three-fourths support in the House and Senate. "I don’t think you can read very much into the numbers," Hutchinson said. "My goal is to get it passed in the authorizing or special session by a majority vote and to be able to succeed in the appropriation session."