2013 Legislative Session

On January 14, the Arkansas General Assembly will get cranked up. This will certainly be a very interesting session. The Republican Party has the majority (although very slim in the House) on both ends of the Capitol for the first time since Reconstruction. Medicaid is facing a $138 million shortfall that will have to be closed by one of two means: increasing revenue or cuts to reimbursement and/or services.

The Beebe administration is arguing that Medicaid expansion may be the best solution for dealing with this shortfall. Some are scratching their heads trying to understand, but it’s actually basic math combined with accepted principles of economic development.

Many people currently on Arkansas Medicaid can be moved to the expanded category where the feds will cover 100 percent of the costs as opposed to the current 70 percent. Then in two years, as the state’s financial share of this expansion begins to move upward to a maximum of 10 percent, the economic impact from over $900 million in new federal dollars should be more than enough to make up that 10 percent. The $900 million would be paid out to all sorts of health providers and other entities, who hire new employees, purchase more goods and services and generate increased tax revenue (sales taxes, income taxes, payroll taxes, etc.).

Medicaid expansion is likely to be one of, if not THE major issue for the session. It takes a vote of 75 percent of both the House and Senate to make it happen. That’s not easy under any situation but given the current politics of Medicaid it will be extremely difficult.

Many individual physicians have honest and justified reservations about expansion, and some of those concerns are shared by legislators. These will have to be addressed if there is going to be any chance for extending health coverage to 250,000 uninsured, working poor Arkansans.

It is hoped by many that with this expanded population the state can implement program improvements and patient responsibility/accountability provisions that are not possible with the current Medicaid population.

The problems and challenges faced everyday by Arkansas physicians will get new voices in this legislature. Of the eight members of the Senate Public Health Committee, two are physician spouses, and one is the son-in-law of a physician. One of them, Senator Cecile Bledsoe, will be chair of this important committee. In the House, Steve Magie, MD, AMS immediate past president, is the state’s only elected physician and will serve on the powerful Judiciary Committee where issues relating to tort reform end up. Deborah Ferguson, DDS, will serve on the House Public Health Committee. She is the wife of Scott Ferguson, MD, a former president of the AMS and former State Representative himself.

All of these individuals understand health care issues and particularly those that involve physicians and the patient/physician relationship. Other members of the General Assembly will undoubtedly look to them for advice and understanding of health care issues.
We have major challenges to face. These challenges are really opportunities to improve health care for Arkansans, address the hassles and roadblocks that impact every physician’s ability to care for their patients, and strive, to the best of our ability, to represent the physicians of Arkansas.

By David Wroten, AMS Executive Vice President

Article adapted from the February issue of The Journal of the Arkansas Medical Society