When Gov. Asa Hutchinson unveils his proposed 2018-19 budget this week, most of the attention will be on the state’s Medicaid program and the future of the hybrid expansion that’s provided coverage to thousands of low-income residents over the past few years. The questions that arise will indicate how much of a fight he’ll face to keep the program alive.

With two vacancies in the Senate creating uncertainty about whether the votes are there for the expansion’s future, Hutchinson last week offered a preview of his budget and the argument he’ll make to the Legislature when it returns for its fiscal session in February. The Republican governor touted numbers showing Medicaid enrollment dropped by more than 117,000 people between 2017 and 2018, and said he’s seeking about $488 million less in state and federal funds for the Medicaid budget than he originally had planned.

“They’re rightfully concerned about the state budget numbers and Medicaid growth, and this should give them a higher level of confidence that this trend will continue,” Hutchinson told reporters last week.

Most funding plans need a three-fourths majority in each chamber to pass, and Hutchinson said he expects the hybrid Medicaid bill to be approved again. The Medicaid budget measure passed the Senate last year with 27 votes, the minimum needed in the 35-member chamber.

The governor’s Medicaid budget plan will likely face scrutiny from expansion opponents who have argued the state can’t afford the program and have called for its end. There’s also still uncertainty surrounding the state’s request to move 60,000 people off the program by lowering its eligibility cap and imposing a work requirement on participants.

Legislative leaders say they remain confident there won’t be a budget standoff over the program’s future.

“The Arkansas Legislature hasn’t proved willing to do the deadlock kind of business they do in Washington and I continue to believe we’ll do that and do right,” said Democratic Sen. Larry Teague, who co-chairs the Joint Budget Committee.

Hutchinson and the state Department of Human Services have said the recent enrollment reductions came from deeper eligibility reviews and some participants finding work and moving off the program. They may prompt questions from conservative opponents of the expansion who say the reductions show problems within Medicaid, while they may also face scrutiny from Democrats over who’s being kicked off the program.

“One thing we need to be looking out for is, were there some people who were involuntarily removed from the program that we might feel still need some kind of assistance?” said Democratic Rep. David Whitaker, the House minority leader. “We’re certainly all for efficiency but we don’t want to be throwing people off the program who need the help.”

Though Medicaid is likely to dominate upcoming budget hearings and next month’s session, there are plenty of other issues that could come up about the state’s finances. They include the state’s prison system and whether it needs additional funding after a string of violent incidents that have included attacks on guards by inmates. The hearings will also provide a glimpse at the financial picture the state is in as a legislative task force continues looking at proposals to continue cutting taxes.

House Speaker Jeremy Gillam said he expects most members will be focused on the “big six” agencies: higher education, public schools, Human Services, Health, Correction and Community Correction. He said there will still be some unknowns, including the status of the state’s proposed Medicaid changes, but said he’s not expecting any major surprises in this week’s hearings.

“I don’t think any of us are expecting major, huge swings on anything for next week,” said Gillam, a Republican.


Andrew DeMillo has covered Arkansas government and politics for The Associated Press since 2005. Follow him on Twitter at www.twitter.com/ademillo

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Medicaid to dominate Arkansas budget talks