Republican lawmakers pushed a pair of new arguments against Medicaid expansion over the last two days in the House and Senate Public Health, Welfare and Labor committees. In the House Committee, which met yesterday, Committee Chairman John Burris (R-Harrison) complained that insufficient attention has been paid to possible financial gains for hospitals from newly insured folks on the healthcare exchange. Meanwhile, in the Senate committee this morning, Sen. Jonathan Dismang focused on the possible advantages of a subset of the Medicaid expansion population buying subsidized health insurance on the exchange. Both were strident and sharply critical in their questioning of the speakers, Surgeon General Joe Thompson and UAMS Chancellor Daniel Rahn (each testified before both the House and Senate committees).
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As we noted, Dismang didn’t mention his idea of the state further subsidizing folks between 100 and 138 percent of the federal poverty level (FPL) to buy insurance on the exchange, on top of federal subsidies. But he’s clearly focused on that 100-138 group.
Dismang hectored Thompson, repeatedly asking, “Do you believe that the folks from 100 to 138 percent should be allowed to utilize tax credits that are currently offered in the Affordable Care Act?” He demanded a “yes or no” but Thompson declined, saying that it was not a yes-or-no question.
The source of the dispute: if we expand Medicaid, the 100-138 group will be covered by Medicaid; if we don’t expand Medicaid, they’ll be eligible for subsidies on the exchange (thus, not a “yes or no” question for Thompson, who supports full expansion, but would support the 100-138 group getting subsidies if we don’t expand).