BRIAN CHILSON
BELL
It would theoretically be possible to with, though they will be on guard against anything that chips away too much at the amend the law itself (with two-thirds spirit of the coverage expansion. approval in both houses, the constitution “It is something we’re going to have to allows the legislature to take up non-appropriation legislation during the fiscal seswatch closely,” Leding said. “We can’t necsion). Far more likely is special language essarily just take the 48 Democrat votes tied to the appropriation, tying up the funds for granted. I don’t know where that line would be but I suspect if it was changed if certain criteria weren’t met by next fiscal year. too much, it might become unpalatable What might the tweaks include? Some for some of us. And then we’re in a very of it may come down to creating clearer difficult position.” language and a specific timetable for some Another issue that may come up in negotiations: federal grant money for features already mentioned in the law. DHS is planning during the session to send a outreach, such as advertisements and the trained guides who help with enrollment request to the feds to offer health savings on the newly created Marketplace. Some accounts (a pet issue for Irvin, not to menof these funds have already been blocked tion Sanders and many other Republicans) by Legislative Council, and the outreach to private-option beneficiaries starting in 2015. Republicans could make the appromoney is technically geared not toward priation contingent on federal approval. the private option, but the rest of the Marketplace. The give here would be a condiSimilarly, there may be a request for costsharing or small co-pays for some privatetional surrender of sorts for Democrats; option beneficiaries below the poverty line. Arkansas would have near-universal coverage available but no outreach budget to Again, this is in the law, but Republicans spread the word and facilitate enrollment. are eager for specifics and progress. “It’s a fair concern,” Burris said. “People want While lower enrollment in the Marketplace assurance that we’re on the path we need could lead to higher premiums, opposition to be on with those things.” to become an important antiHeavyoutreach HorshasD’oeuvres Another likely request: a waiver of the Obamacare symbol for many Republicans. requirement that the state pick up the tab Quality As one lawmaker put it, he might be open libations to giving the private option a chance, but for non-emergency medical transportahe didn’t want to have to see “Obamacare tion, a benefit under Medicaid not covered one-on-one Convo WitH tHe artist ads” during the Super Bowl. by private plans. Iowa, which is pursuing a similar privatized version of Medicaid Part of the reason someone like Bell live PerformanCe from tHe funk a nites expansion, recently got a one-year waiver — who would prefer to do away with the on providing this “wraparound benefit” private option altogether — is willing to *Pro tiP $3 off WitH event from the feds. negotiate is the lack of a clear endgame PassWorD tofisbe revealeD All of these would fall under the catto a pure defund strategy during this via soCial meDia egory of “making Medicaid more Republical session. can,” as the Washington Post’s Sarah Kliff “I think it’s fair to say I’ve pushed my put it, noting that the Obama administrano button more than anyone,” Bell said. theasartdepartment.com tion’s desire to get red states to agree to “But I’m only going to vote no when I can accomplish something by voting no. ... So Medicaid expansion has opened the door for conservative reforms. many people believe that because you have thea foundatio That said, these are likely the sorts of the votes to beat an appropriation, you can changes — making implicit portions of the actually accomplish something, and that’s law more explicit, attaching firm deadlines, just not the case. ... At the end of the day, it’s in the best interests of the state if we @theasta following the lead of other states using a can move away from [the private option]. similar approach — that Democrats can live
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