The governor announced that he would call a special session to begin April 6 for the legislature to consider changes to the state Medicaid program.
Changes to Medicaid are usually difficult because it is such a large and expensive program. Changes are needed though, because it has been growing as a category in the state's overall budget.
Last fiscal year, the Arkansas Medicaid program spent $5.2 billion. According to a consultant hired by the legislature, conservative estimates are that Medicaid spending will increase to $6.9 billion over the next five years.
Ten years ago the state Medicaid program spent $3.15 billion. Of that amount, $2.3 billion was federal funding.
Medicaid covers about 512,000 Arkansans under the age of 20, about 60,000 Arkansans over the age of 65 and about 206,000 Arkansans from 21 to 64 years of age. They have low yearly incomes and some have disabilities.
Medicaid pays for two-thirds of the care of nursing home residents in Arkansas. More than half of Medicaid spending, or 55 percent, is for care of the elderly and adults with disabilities. About 66 percent of Medicaid beneficiaries are below the age of 21, but they account for just 45 percent of total spending.
The governor's proposed changes to Medicaid would encourage employers to offer health insurance to workers, and if necessary the program would pay a portion of the premiums. Health beneficiaries would be required to sign up for job training and job placement. Another change would require some Medicaid patients to make copayments.
The special session will be a week before the beginning of the fiscal session, when legislators adopt state agency budgets for next fiscal year.
The legislature has generally considered only budget bills during fiscal sessions. For example, during the 2014 fiscal session the legislature enacted 300 bills and all but one were spending measures sponsored by the Joint Budget Committee. During the most recent regular session, in 2015, the legislature enacted 1,289 bills. Fiscal sessions take place in even-numbered years and the lengthier regular sessions take place in odd-numbered years.
Setting limits on Medicaid spending in the special session will be an essential first step in the budget writing process that will culminate in the writing of the overall state budget during the fiscal session.
The other major categories of state spending are public education from kindergarten through grade 12, higher education and prisons. The state funds pre-kindergarten programs too.
Other law enforcement functions funded by state government are supervision of parolees and people on probation, the State Police, the state Crime Lab, the attorney general's office and appellate courts. The state Law Enforcement Training and Standards Commission operates academics that train police officers.
Also, the state maintains and builds highways with special revenues, such as the motor fuels tax and fees on heavy trucks. Relatively smaller agencies include the Parks and Tourism Department, the Economic Development Commission and state Revenue offices where people can renew their car tags and drivers' licenses.
The state Military Department is in charge of the Arkansas Air National Guard and Army National Guard. The Department of Environmental Quality enforces clean air and clean water laws, and regulations governing landfills and hazardous waste storage sites.