Medicaid Takes a Back Seat In the 89th General Assembly (AP Analysis)

The Arkansas State Capitol in Little Rock.

LITTLE ROCK — What happened to the Medicaid session?

Despite all the talk before lawmakers gathered at the Arkansas Capitol that Medicaid’s finances and future would overshadow just about every other issue, there’s been scant attention paid to the $5 billion program and efforts to expand it under the federal health care law.

Medicaid is instead taking a backseat to a growing number of conservative causes — new abortion restrictions, relaxed gun rules and voter ID, to name a few — that are easily winning support now that Republicans control the House and the Senate.

As this year’s session enters its sixth week, those GOP-backed proposals have taken center stage, rather than discussions on whether Arkansas should expand the Medicaid program by 250,000 people under the federal health care law.

Democratic Gov. Mike Beebe spent much of his State of the State address urging reluctant Republicans to support the expansion, but legislators are leaving open the possibility of wrapping up this year’s session without addressing the top agenda item, and wait instead for a special session or next year’s fiscal session to tackle the issue.

“We still have tons of unanswered questions,” said Rep. John Burris, a Republican from Harrison who chairs the House Public Health Committee.

Burris and other GOP lawmakers say they still have time to address the Medicaid expansion but want more details from the federal government on the flexibility Arkansas may have to craft a compromise proposal.

The questions include whether President Barack Obama’s administration will reconsider its position that states can’t opt for a partial expansion and still receive full federal funding for the first three years. Beebe has also asked administration officials whether Arkansas could allow those making just above the poverty level to purchase private insurance on the exchange rather than go on the expanded Medicaid rolls.

Beebe is ruling out the possibility of a special session or a fiscal session to take up Medicaid, but at the same time is quick to say he won’t hurry legislators into making a decision just yet.

“They should not be rushed or forced into a decision in the next couple of weeks, but sometime between now and the end of the session, they ought to be able to gather enough information they want to gather from as many sources” to make a decision, Beebe told a group of county judges last week.

Beebe told reporters he’s willing to keep talking with the federal government about other proposals, but warns: “At some point you’ve got to quit asking and at some point you’ve got to get to a finalized version so people can vote up or down.”

Republicans say they expect to see more movement in the coming days on Medicaid, especially on proposals that GOP lawmakers say will help the program save money. Republican legislators say the recent release of an audit that found Medicaid paid more than $1.3 million to ineligible people in Arkansas since 2009 backs up their call for more controls on the program and throws into question the possibility of expansion.

Beebe and DHS officials, however, note that the findings represent a small part of a $5 billion program that serves more than 776,000 people in the state.

“There’s been a lot of focus on other issues up until this point, but I think you’ll see more and more focus on the Medicaid discussion moving forward,” said House Republican Leader Bruce Westerman, R-Hot Springs.

The extra time may give Beebe leverage as more Republican-led states such as Arizona and Ohio opt for expansion despite their governors’ opposition to the federal health care law. For Republicans wary of expansion, the time may give them more details on the flexibility those states have been given as guidance on what an Arkansas compromise could look like.

Senate President Michael Lamoureux, a Republican who has held out hope for such a compromise, said the pace the Legislature is moving on Medicaid doesn’t mean the possibility of such a deal is dead.

“It’s not time to panic yet,” Lamoureux said.