Both the House and Senate gave approval of the budget for Arkansas Works which, through Medicaid funding, provides insurance to approximately 285,000 people in the state last week.

The Senate did so on Tuesday by a vote of 27-2 with two Senators not voting and another voting “present.” The measure drew approval from two Republican senators who had long opposed the Affordable Care Act program.

Passage required a three-fourths majority, or exactly 27 votes, and was accomplished with longstanding opponents of the program voting in favor of the budget. Those were Sens. Terry Rice of Waldron and Alan Clark of Lonsdale.

Sen. Gary Stubblefield, R-Branch, who represents Logan County, was one of the two non-votes.

“One of the main reasons I didn’t vote for it is we’ve still got 750,000 people in this country that are the most needy of all. These are the ones that Medicare was designed for. These are not healthy, able-bodied people like the ones on Arkansas Works,” said Stubblefield. “Since Obamacare went into place, and Medicaid expansion went into place back in 2013, 22,000 of these people have died in these Medicaid expansion states waiting on health services.

“And we’ve still got a waiting list here in Arkansas,” he said.

Stubblefield has never voted for anything concerning the program, but he said last week he did listen this time, he just still wasn’t convinced.

“I asked her what her opinion was on freezing enrollment,” Stubblefield said. “She never really answered the question. I already knew that states like Maine and Arizona had frozen their enrollment and dropped about a third of the enrollees. I knew it worked.”

Funding for the program, Stubblefield said is his concern.

“Of the increase in state budget, $142 million out of $176 million is going to Medicaid expansion. That is this year and in 2020 we’ll be paying $200 million per year, if the enrollment stays the same,” said Stubblefield. “When we get to that point, you will have to reduce services somewhere else, it will either be education, prison system, health department in order to finance DHS.”

Arkansas Works is projected to cost more than $2 billion in the upcoming 2019 fiscal year, with the vast majority coming from federal funds. Arkansas’s share is expected to be about $136 million. Under the Medicaid expansion, Arkansas bears 6 percent of the cost of the program in 2018, rising to 7 percent in 2019 and maxing out at 10 percent in 2020.

The House approved the budget last Wednesday by a vote of 79-15. Jon Eubanks, R-Paris, was among the 79 vote majority. There were also five members who did not vote or voted “present” in the 99-member chamber.

The votes occurred following an announcement Monday that the state gained approval for a work requirement for those in the program age 19-49 who are able.

Some, like Rep. Michael John Gray (D-Augusta), contend passage of the work requirement had no impact on the passage of the program’s budget. Stubblefield almost agreed.

“I don’t think the work requirement got this thing passed,” Gray said. “I really think they’re seeing what’s happening in Kansas and Oklahoma where these major tax cuts have taken place for political gain, and they haven’t had Medicaid dollars to shore it up.”

“I think everybody had their mind made up how they were going to vote before. Most of the people in the Senate that these work requirements are more of a symbolic gesture to force people to go to work,” said Stubblefield. “You cannot force people to go to work whether it’s a Republican or Democratic administration.”

Stubblefield also took a shot the work requirement.

“If an able bodied person signs up on Arkansas Works and they don’t meet their work requirement, you know what they can do? They go straight to ER. When they go to the emergency room, then they’re automatically re-enrolled on Medicaid, and then the reimbursement is like 70-30 so it’s going to cost the state more when they’re kicked off,” said Stubblefield.

“They’re more like work options. One of the requirements is you can look for a job for 40 hours in a month. You can go online and do a study course on health care for 20 hours, in a year, you’re still in compliance with the work requirement,” said Stubblefield. “The thing about it is it’s going to cost $3 million to track all this and it’s impossible to track this.”

Stubblefield adds that studies have shown work requirement doesn’t work for health care, but do work for food stamps.

“Unless you have a drastic change in mindset we’re never going to get out of this entitlement mentality,” said Stubblefield.

(The Arkansas Nonprofit News Network contributed information used in this report.)