House Convenes

I am by the member staff press and guests in the gallery standing be led in prayer by the house chaplain Dr rex mourn retired pastor Emmanuel Baptist church in Little Rock and remain standing for the pledge of allegiance to be led by representative Lane Jean. Let's pray. Father we come today and our prayer thanking you we want you to know that we are grateful people. We're grateful that you have all power and all knowledge that you are ever present. We're grateful that you know us individually and that you form to sign that you've given each one of us a purpose in this life. We pray that we might accomplish that which you've placed us here to do. Bless the women and the men of this house and bless them and their deliberation continue to give them the strength and wisdom as they pressed forward in the session. And father would also confess to you that we are simple people. We need your help but we need your forgiveness and we're keenly aware of the price that was paid as we celebrate this holy week holy season and we pray in Jesus name amen. Members please indicate your presence by pushing yellow present button prepared machine Mr Clerk. Cast about Mr Clark. With one hundred members chair at present the chair sees a quorum are there any request for leave obviously not because there were all one hundred here. Represent Fredrick Love moves we dispense the reading of previous day's Journal without objection so ordered are the reports from select committees read reports Mr Clark. Mr Speaker we are committee on joint budget to whom was referred house bill ten seventy seven house bill ten eighty house bill eleven sixty seven Haskell fifteen sixty seven beg leave to report we had the same under consideration here with trying to sing the recognition I do pass respectfully submitted Lane Jean chair. Other Reports from standing committees reports Mr Clark. Mr Speaker we are committee on education to whom was referred house bill seventeen hundred House resolution ten twenty two Senate bill sixty four Senate bill two thirty five Senate bill two six fifty Senate bill three forty nine Senate bill three eighty nine three Senate bill three oh seven four oh seven rather beg leave to report we had the same under consideration here with trying to sing the recognition do pass respectfully submitted Bruce Cozart chair Mister Speaker we are committee on education to whom was referred house bill seventeen forty four beg leave to report we've had the same under consideration here with trying the same with the recognition do pass as quickly submitted Brian Evans vice chair Mister Speaker we are committee on education to whom was referred house bill seventeen seventy beg leave to report we have to have the same under consideration here with trying the same deregulation do pass as amended number one respectfully submitted Bruce Cozart chair. Is there any unfinished business are there any Executive communications. Representative McKenzie moves we place Senate bill two O. four back on second reading for the purpose of amendment without objection read a member number one Mr Clark a minimum one Senate bill two O. four. President kids you're recognized to explain the amendment. Thank you Mr Speaker my amendment my bill just adds and sponsors Richard good vote. I candidates as explained the bill would anyone like to speak against the bill. We would like to speak for the amendment. Represent McKenzie is closed for the amendment the question before the House is the adoption of amendment everyone to Senate bill two O. four all in favor say aye. Any opposed the amendment is adopted. Morning hour is indeed represent Penzo recommends we can current Senate amendment number one to House Bill fifteen forty eight Mr Clark please read Senate Amendment number one Senate Amendment were one to House Bill fifteen forty eight. Represent Penzo you're recognized to explain a member number one. This amendment just adds a Senate hand Senator Hammer is a Senate sponsor thank you president Penzo has explained the amendment would anyone like to speak against the amendment. Would anyone like to speak for the amendment. President and those close for the amendment the question before the House is concurrence with Senate Amendment over one to House Bill fifteen forty eight per machine Mr Clerk. As everyone voted. Has everyone voted. Cast about Mr Clark. By a vote of ninety four U. A. zero nine zero president you've concurred in Senate amendment or one to House Bill fifteen forty eight. Members for a pass over house bill fifteen sixty three Mr Clark please read house bill sixteen ten. House bill sixteen ten by representative Gazaway concerning the use of student restraints in public schools or educational settings person Gazaway you're recognized to explain the bill. Thank you Mr Speaker colleagues this simply codifies existing guidance that the department of education has an effect on the use of physical restraints and seclusion in schools it is not not a band or a or a specific prohibition or blanket prohibition on the use of restraint and seclusion it allows school districts to still be able to corral kids who are acting up or try to run away simply the use of physical restraints like taping a child to a chair or locking a child in a closet those things are prohibited that's already in the department of ed guidance is just codifying the guidance that's already in place the department of ed came and spoke during the committee for the bill or during that section of the bill there attorney testified they're not oppose the bill that I am aware of and so with that I'm happy to answer any questions. Senate appreciate a good vote thank you president Gazaway is explain the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. President gas was close for the bill the question before the House is the passage of house bill sixteen ten prepared machine Mr Clerk. As everyone voted. As everyone voted. Cast about Mr Clark by a vote of eighty four yeas one nine zero present the bill is passed Mr Clark please read house bill seventeen fifty. House bill seventeen fifty a representative Womack to allow continuous public school district to consolidate with an effective district under certain conditions president Womack you're recognized explain the bill. Thank you Mr Speaker colleagues this bill very simply put something in law that allows for to school districts have been consolidated where it may not be a good union to to change the union and combined with a different school district and I'd be happy to. Take any questions. I would appreciate a good vote. Person Womack is explain the bill would anyone like to speak against the bill. We would like to speak for the bill. President Womack is closed for the bill the question before the House is the passage of house bill seventeen fifty prepared machine Mr Clerk. Has everyone voted. As everyone voted. Cast about Mr Clark. By a vote of ninety eight zero nine three present the bill is passed Mr Clark please read house bill seventeen seventy four house bill seventeen seventy four by representative Penzo to amend Arkansas constitution Amendment ninety eight also known as the Arkansas medical marijuana amendment twenty sixteen and to modify requirements concerning the pharmacist consultant. President Penzo you're recognized to explain the bill. Thank you Mr Speaker. House bill seventeen seventy four has been amended. Initially I had some proposed language the dispensaries came back with some language and that's with the we have the forces the amended language pretty much what this does is just if you remember several years ago I'd ran a bill that made it to where pharmacists were made available FOR for patients or customers of dispensaries that way that they could have there. Prescription drug drugs reviewed and make sure there weren't any country indications are interactions with the their existing medications so I would say there there were some farm Spencer is it worked it hearing to that so I propose some languages the the good actor dispensaries came back with some language and I was told that was more than I wanted so we can scale it back in and this is what we came up with dispensaries shall post signage at the check in at the dispensary they also have to put that the pharmacist is available to the customer on their website and they'll give the pharmacist contact information on the card to the to the patients when they come in to the dispensary Any questions. Appreciate a good vote. Represent Penzo is explain the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. President Penzo is closed for the bill the question before the House is the passage of house bill seventeen seventy four prepared machine Mr Clerk. Everyone voted. Is everyone voted. Cast about Mr Clark. By a vote of ninety one Yeas one nine one present the bill is passed. Members are doctor today is Dr Kimberley garner of Little Rock who I understand is represented Richmond sister in law. And our nurse today is Brenda Hewitt. Passover house bill seventeen fifty two. Mr Clark please re house bill seventeen forty eight house bill seventeen forty eight a representative would occur to amend the law regarding the sale of alcohol beverages on Sunday and to allow the governing body of the city or county to call a referendum election for the sale of alcoholic beverages on Sunday. Represent would occur you're recognized explain the bill. I thank you Mr chair Mr Speaker Good afternoon colleagues. On house bill seventeen forty eight when you look at the title I want you to skip the first part because this is an alcohol bill. It's the second clause enabling form courts in city governments. Two. Placed a referendum for Sunday sales on the local ballot. Of all the bill does. Two almost identical little phrases added to. It doesn't established Sunday sales in any jurisdiction in the state. It doesn't put it on the ballot in any jurisdiction in the state it's a local government bill that empowers our city councils and boards will quorum court to have a second method currently it's restricted to petition only this will allow city councils are to be boards warrior quorum court to place it on the ballot for local option tax coming to use me election. That's it. I appreciate a good vote. President what occurs explain the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. President Whitaker is closed for the bill the question before the House is the passage of house bill seventeen forty eight per machine Mr Clerk. As everyone voted. As everyone voted. Cast about Mr Clark. By a vote of forty three eight thirty nine nays and zero present the bill has failed Mr Clark please read house bill seventeen fifty four house bill seventeen fifty four by representative Cavenaugh to amend the law concerning child support. Representative Cavenaugh you're recognized to explain the bill. Thank you Mr Speaker I this is just a simple housekeeping bill to amend the existing code to be consistent with legislative changes that we made in the two thousand nineteen session and with that I'd appreciate a good vote. President Cavenaugh has explained the bill would anyone like to speak against the bill. We would like to speak for the bill. Representative Cavenaugh is closed for the bill the question before the House is passed house bill seventeen fifty four prepared machine Mr Clerk. As everyone voted. As everyone voted. Cast about Mr Clark by a vote of eighty five Yeas five nays and for present the bill is passed Mr Clark please read house bill seventeen eighty eight. House bill seventeen eighty eight by representative Lanny Fite to establish broadband improvement district president fight you're recognized to explain the bill. Thank you Mr Speaker this bill right here's a broadband improvement district bill what it allows allows improvement districts to engage with the of the private sector in which to the extent of broadband out into the community it will be a public private partnership was assigned be happy to answer any questions. And I appreciate a good vote. Represent fives explain the bill would anyone like to speak against the bill. We would like to speak for the bill. Represent fight is close for the bill the question before the House is the passage of house bill seventeen eighty eight prepared machine Mr Clerk. As everyone voted. As everyone voted. Cast about Mr Clark by a vote of ninety seven yeah zero nine zero present the bill is passed Mr Clark please read house bill sixteen eighty eight House Bill sixteen eighty eight by representative Cllr to amend the joint council and municipal solid waste disposal act to require the county municipal members have budgetary approval authority. Represent a clear you're recognized explained the bill. Thank you Mr chairman. This is a local issue bill that's going to do a little bit of updating it was brought to us or brought to me to the hot spring county solid waste authority quorum court the cities of Donaldson midway in friendship and what it does there is a line that originally allowed an independent independent development corporations nonprofit to have voting rights on that board. That particular nonprofit has been nonexistent or dormant for over a decade so what this does is just allows that to be pulled away and clarifies that the voting members on the board for taxpayer dollars is the participating municipalities and counties in the solid waste districts so. There's not any questions. I would like a good vote thank you. Represent McClures explained the bill would anyone like to speak against the bill. We would like to speak for the bill. Represent a close close for the bill the question before the House is the passage of house bill sixteen eighty eight prepared machine Mr Clerk. As everyone voted. As everyone voted cast about Mr Clark. A vote of ninety five Yeas zero nine zero present the bill is passed Mr Clark please read Senate bill two twenty nine Senate bill two twenty number represented Lowery to amend the due date for semi annual reports of burial associations represent Lowery recognized to explain the bill. Thank you Mr Speaker This Is Senator Wallace is bill I hardly ever get to say this when a president a bill but this a little of bill that don't do much. burial associations have reports that they have to file in the original legislation according to his presentation. Which twenty years ago will the reports to become more and more extensive so they have just asked for thirty. Thirty additional days to be able to produce the reports in the file the. So it's it's a no nonsense bill not appreciate your support. Percent Lowry's explain the bill would you would like to speak against the bill. Would anyone like to speak for the bill. Represent Lowery is closed for the bill the question before the House is the past Senate bill two twenty nine prepared machine Mr Clerk. As everyone voted. As everyone voted. Cast about Mr Clark. By a vote of ninety four U. A. zero nine zero present the bill is passed Mr Clark please read Senate bill one sixty three. Senate bill one sixty three by representative mark berry to create the Arkansas military affairs council act to establish a military affairs grant program and to declare an emergency. Simsbury you're recognized explain the bill. A day to be an American thank you Mr Speaker in the colleagues Arkansas has been a leader in the military and defense secretary for for decades and they continually try to grow the military industrial complex here in Arkansas so in two thousand fifteen the governor began a proactive report up approach and he established the Arkansas military affairs committee within ADC Senate bill one sixty three will permanently established the Arkansas military affairs council under the Arkansas military affairs council acting codified the Military Affairs grant program and the military affairs director position ADC in Arkansas we support the sixty two thousand military related jobs will labor income of three billion dollars which generates three hundred thirty million dollars income every year by the most recent military affairs economic impact statement so this bill has no impact on revenue in every and receive unanimous support in the house in the Senate and I appreciate your support thank. Senate buried six plane the bill would anyone like to speak against the bill. Would anyone like to speak for the bill president very is closed for the bill the question before the House is the passage of Senate bill one sixty three prepared machine Mr Clerk. Voting on the bill in the emergency clause has everyone voted. As everyone voted. Asked about Mr Clark. By a vote of ninety four U. A. zero nine zero present the bill emergency clause are passed Mr Clark please read Senate bill three ninety seven Senate bill three ninety seven by representative speaks to create the higher education consumer guide act. President speech you're recognized to explain the bill. Thank you Mr Speaker Senate bill three ninety seven is that a little bill but it does a lot of stuff. This is a higher education bill it's a bill that we've been wanting for our call at college students or students to prepare to go to college what it does it has a guide that they have combined this isn't a education has combined and it will give these it's a student sets get getting ready to go to college the cost of all of the different colleges it also talks about the in mission the success rates and has many more things to prepare them to make a great a good decision of going on to college. Each student will be provided with a link of this copy and it will also that you they will give them the link are they will give them a paper copy and show them how to go about going into this it's it's been done very of where it's going to be easy for them and I would really appreciate a good vote. Represent speaks is explain the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. Represent speaks is closed for the bill the question before the House is passage of Senate bill three ninety seven prepared machine Mr Clerk. As everyone voted. Has everyone voted. Asked about Mr Clark by a vote of ninety four U. A. zero nine zero present the bill is passed Mr Clark please read Senate bill one sixty one. Senate bill one sixty one by representative didn't all as to allow a public school or public school district to offer a hunting safety course as part of its curriculum. Represent Gonzales you're recognized to explain the bill. Thank you Mr Speaker. Because hunting is a big deal in the state we had fewer and fewer hunters. we've had few if you're if you're Hendren by license in the state And this will hopefully help out out by allowing kids to take a hundred education course while they're in school currently it's it's offered online is offered at different times on weekends I have to give up you know what eight ten hours on the weekend to get this course done this would allow it to be done as part of the course curriculum so I take any questions. Represent Gonzales explained the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. Represent Gonzales is closed for the bill the question before the House the passage of Senate bill one sixty one prepared machine Mr Clerk. As everyone voted. As everyone voted. Cast about Mr Clark. By a vote of eighty seven yeas five nays and zero present the bill is passed. Mr Clark please read senate bill four ninety. Senate bill four ninety a representative Wardlaw to amend the law concerning the code of ethics for public officers and employees and to amend the law concerning holding office if convicted of a public trust crime president Wardlaw you're recognized to explain the bill thank you Speaker just brings the mayors and local elected officials in line with the same ethics that we're under solid does present a good vote. President Wardlaw is explain the bill. We would like to speak against the bill. Would anyone like to speak for the bill. Represent Wardlaw is closed for the bill the question before the House is pastor Senate bill four ninety prepared machine Mr Clerk. As everyone voted. Is everyone voted. Cast about Mr Clark by a vote of ninety seven yeah zero nine zero present the bill is passed Mr Clark please read Senate bill five hundred. Senate bill five hundred by representative Payton to authorize the issuance and renewal of a special license plate to remote the buffalo river in support economic development and Searcy County. Empate you're recognized explain the bill. Thank you Mr Speaker colleagues probably the best bill Senator Irvin sent to us this year appreciate a good vote. President Payton is explain the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. Represent Payton is closed for the bill the question before the House is passed to Senate bill five hundred prepared machine Mr Clerk. Everyone voted. Everyone voted. Cast about Mr Clark by a vote of seventy seven yeas three nays and twelve present the bill is passed Mr Clark please read Senate bill five twenty five. The five twenty five a representative warned to reverse changes made under ACT eight nineteen of twenty nineteen and return the administration collection of the franchise tax to the Secretary of State into the claim number it's a person born you're recognized to explain the bill. Thank you Mr Speaker colleagues this bill is to reverse what was accomplished with ACT eight nineteen and two to two thousand nineteen that transferred the collection of transfer taxes from the secretary of state's office of the department of finance and administration. It's believed that this act has resulted in hardships in compliance issues for Arkansas taxpayers this bill will allow for the return of collection and administration franchise taxes to the Secretary of State this bill will carry with it an effective date of may first two thousand twenty one. I would appreciate a good vote. Percent worn is explain the bill would anyone like to speak against the bill. Would anyone like to speak for the bill. President warns close for the bill the question before the House is the passage of Senate bill five twenty five the machine Mr Clerk. Voting on the bill in the emergency clause. As everyone voted. Is everyone voted cast about Mr Clark. By a vote of ninety three eight zero nine zero present the bill emergency clause or passed Mr Clark please read Senate bill fourteen in the bill for ten by representative grade ten men title twenty three Arkansas Code to ensure the stability of the insurance market in Arkansas and to create the Arkansas Health an opportunity for me active twenty twenty one in the Arkansas Health an opportunity for me program. President great you're recognized to explain the bill. Thank you Mr Speaker hi we were making record time until this bill today. And so. In my master stay on the desk. So what this bill does is it essentially keeps our Medicaid waiver in place for expanded Medicaid I've explained this bill so many times the kind of start a different place every time I go over the bill I do it kind of just from memory with notes in front of me. When. What we call upon the care the affordable Care Act came into place Arkansas decided to expand Medicaid I was in here at the time I think there are a few members still here from that we did that in two thousand thirteen I was called the private option at the time and then as the private option sun said It then I was here I believe it was two thousand seventeen sixteen or seventeen we enacted something called Arkansas works so Arkansas works is now getting ready to sunset this year so what this is is essentially a replacement for that waiver to start next year we have to apply three CMS of with this new waiver so what this bill is is just the framework for the waiver request that that that Medicaid DHS is going to make to CMS. And I'll start out I've said this publicly I said in a press conference I said it yesterday is that I campaigned against this idea you can ask for representative Tommy re and that was one of my big things I campaigned against with him I thought it hard my first session and then representative Bragg let me be is where he is let me be is designated on the healthcare task force in two thousand fifteen and sixteen and I went into that completely against. This right here and through that year a year and a half long process what I realized and this may not be how everyone here feels and I know it's not is that even though I might disagree with some of the things that this does philosophically functionally pragmatically for the state of Arkansas it makes sense for us it works for us and we've had fifty seven hospitals between Arkansas and all are border states close in the last ten years Arkansas has only had one of those fifty seven those other states around us have not expanded Medicaid until this year two well actually in twenty two of the state's expanded Oklahoma and Missouri had a ballot initiative to expand Medicaid. I think it Louisiana may have had me check my notes I think they did in two thousand sixteen so I'll take that again before I leave the well. So what I learned is it's helped our hospitals it's helped our constituents we also had So what we look at is something called federal poverty level so we Medicaid covered zero to seventeen percent of the federal poverty level we Meeks banded Medicaid that's tied for the lowest in the country with Texas they also had seventeen percent are still have seventeen percent of the federal poverty level that they cover with expanded Medicaid we now go up to a hundred and thirty eight percent of the federal poverty level so we did expand that coverage quite a ways out. And. So that we can tell you what this bill does and how it's different so it continues the waiver. We don't expand the population at all I got that question yesterday we're not adding anyone new hits the same population that we had before this one does have a minimum and a maximum on it where in the past we haven't always had a minimum to keep the market place stable or a maximum for kind of budget neutrality for the state so there's a minimum and maximum that we will last CMS for having one of the innovative things that I like about this he is a lot of this came out of talks that DHS had with legislators over the last year to. Is something that what they're calling a life three sixty homes so there are three different types that they've come up with and so what they decided was not everybody in this population should be treated the same we've never really measured outcomes we just give in the qualified health plans which we have two of those in the state the cover this population we just give them a per member per month amount and sit here cover them whatever their needs are with not really attracted or held them accountable in the past. So one of the things that we're doing is world a rural homes in the community that critical access hospitals across the state will be the hubs for that peace that peace and the most important part to me in that piece is a Q. crisis units so for behavior health if you have someone well with severe mental illness that's in an acute phase instead of holding them in the E. R. especially like in the rural parts of the state having to wait you know twenty four forty eight seventy two hours to ship them somewhere you actually have the resources in that small hospital to treat that patient and keep them there so that's huge for me to do across the state then we've got the success life three sixty homes in that demographic is what they're gonna be looking at targeting is veterans formerly incarcerated a foster children her foster kids are not children but foster kids who have aged out of the system and so looking to provide economic development any behavioral healthcare needs anything that they need to help advance them because this isn't of a land all of you know we want to put you in this expanded population and leave you here the goal is to get you here and then work with you through through the W. S. three trying to get your health care better two different avenues to get you out of the program and you come out on the top side that's the gold of what this program is and then the third piece is the maternal homes and those will be operated throughout the state to buy only by birth in hospitals so like I don't have a birthing hospital in my district but I have a close they would be able to service my district with that maternal home and so that focus will be on high risk pregnancies. And then finally the other big piece of the bill this came from working with the legislators is the accountability piece so I told you we've never held the health plans accountable for any outcome service here's the money to cover the patient cover the beneficiary so this essentially has what right now we have thirty one matrix in place in those thirty one matrix are going to be tracked and CMS Medicare Medicaid a lot of other insurance plans already have metrics in place and we're going to hold them to that so here's your baseline and if you've got a patient with let's just say aye Daddy these we're going to watch your A. one C. if that you know if the average A. one C. for their population doesn't go down to what we think it should be. Then there are in the in the contracts there will be financial penalties we've never had financial penalties in place for the the insurance plans before. And this isn't just DHS administering this it is it just the legislature what we've come up with is an Advisory Council and there's a lot of members on it I mean it's got chairs of public health chairs of education trying to think through all the chairs are maybe insurance and commerce is on here today along with a lot of secretaries to essentially oversee this and then also report to the legislature so that's the crux of what the bill itself does not know what might be here awhile but I'd be glad to take any questions. All right see no that's awesome thank you. President gray's explain the bill would anyone like to speak against the bill represent Miller you're recognized to speak against the bill. Never been late before. Thank you Mr Speaker. Representative great. I'm still glad I wrote you a check for your campaign. When you first ran so it's odd that I'm down here. I misspeak on this bill that that you're running the represent grazing good friend of mine and what I'm about to say is in no way directed towards her personally. But. I've been here this is probably my fifth session. Speaking against this very thing I know the reality of it I know a bunch dollar takes a hit yes and that matters or whatever but what I'm about to say is for the people that. Maybe watching the people who are getting the shaft. Because of this program. Thank you need to know that there are a few of us. I want this to be better. We have a two tier system in Medicaid. Everybody will agree to that there's no way to dispute it. If you're on the if you're on the qualified health plans on the Medicaid expansion free insurance you have better insurance than our school teachers in our state employees Dan and Dave here about everybody else in the state you have better insurance. If you are a recently disabled persons. You have to wait two years. Before you can get Medicare. I know because I've been there. This bill does not affect me personally. I pay for working disabled Medicare that's my primary and. The folks there are people are most vulnerable. Are disabled are elderly. Are finding it harder and harder. You get access to care because we have fewer and fewer doctors and specialist and so forth that are taking traditional Medicaid patients. They'll take all of the. All. Of the Medicaid expansion insurance patients that they can get and I don't blame. I get paid more money. It's it's a shame what our Medicaid reimbursement rates are I read that. The folks let me tell you something by passing this bill. We're not fixing anything. We have an opportunity. We have an opportunity to level the playing field. There is no denying that the state would save money if we were not paying insurance premiums. What can we do with those savings. I would lobby and advocate hard for raising all Medicaid reimbursement rates I think there's a lot of missing both parties that would agree to that. But you know what we're never going to get there. If we vote this out. And that somebody needs to say it we need to level the playing field we need to make things fair here's the reality. The insurance companies in the law. Are required to spend eighty percent of the revenue from the state all medical loss that's taking care of sick people. That leaves twenty percent now some can argue and and they'll make the argument that some of our insurance companies one of the two is spending more than that. So they're making ten. Forty percent on a two billion dollar program is four hundred million dollars a year in profit I don't care if you call an administrative cost it's profit. Insurance companies are making a killing. Awful what's being done here while our most vulnerable people in the state of Arkansas are getting screwed. And it's a shame. And I know it's a big problem. And there's a lot of work to be done. I'm willing to do it and I think most of everybody in here is willing to do it but the the first step. It's got to be to level the playing field and let's see what we can do to raise all reimbursement rate. I will take any questions if there are any. I'd ask for a no vote thank you. Represent Miller spoken against the bill we would like to speak for the bill. Would anyone like to speak against the bill represent Bentley you're recognized to speak against the bill. Collins before I get started I want to say it like represent Miller that I respect represent great immensely she's does a lot of work on health care in our state and run hospital will and things out there in the district but I want to just really give you some numbers I know some of you are this is your first time to vote on this bill and you need a little more information so I want to give that to you the first thing I wanna do is just really reiterate what representative Miller had just said our Medicaid system is broken it's very broken it's been broken since I've been here and every year that I've been here I think I've given the same speech is broken and we need to fix it and if we vote for this bill today we're not going to fix it we have all of us have constituents in our district that are on Medicaid and when I called to get an appointment with the physician. Forget it. And that's why they end up in the E. R. and then we spend more money because they're in the E. R. because they can't see a position and why can't they get the positions office because the Medicaid reimbursement rate is half of what Medicare is an Arkansas has won the lowest Medicare reimbursement rates in the nation and they only get half they can't afford to see him that's why in your district and in my district we don't have a small positions offices anymore because they cannot afford to run their own office is a ridiculous amount of money and have to spend just to keep up with all the codes that have to keep up with to get their money back and it wasn't the representative Murdock they would have even seen race into Nelson was we thanks represent Murdock last session we push for rate review so for the first time in fifteen years they get a five percent increase and if he hadn't done that we would need even send a five percent increase for these positions and what came before committee I said five percent after fifteen years is ridiculous so we have to beg and plead for another three percent to get rid Medicaid reimbursement rates raised by eight percent if the physician sees a Medicaid patient they lose money if the hospital sees Medicaid patients they lose money so Arkansas its nine Arkansas saying we have we're right forty eight the nation when we started this you know what we are today we're forty eighth in the nation because we're not approving health because our patients cannot be seen Medicaid patients are not being seen because the positions can afford to CM and again we're looking at here today we're gonna spend eight billion dollars and twenty twenty one on Medicaid eight billion dollars and we can't even have our for our for our constituents being seen and we're gonna spend eight million dollars it's ridiculous I know that you guys are hearing if we don't vote for this that are small hospitals are going to shut down we know what there's another bill and represent Miller has another bill to do fee for service for everybody in this fix the system let's raise the reimbursement rates or physicians can see. See our patients so we can have better health outcomes so we can help our small rural hospitals if we just set aside a trust fund to help our small rural hospitals let's do it I'm sure all for at least look at it but we have a broken system we just add more money to it we're not fixing a blessed thing. You know what we have seventy eight members in this house the Republicans have standing conservative values we have a voter mandate across the state to fix things to change things I'm tired of voting for the same old thing every year we went down here. We can fix it if we will work together for will stand up and say it be the people's house we stand for the people of the state. We don't want to spend eight billion tax dollars from people for tax dollars. On a broken system. I want to help maternal mortality rates in Arkansas that's why did the midwife bill there's some great things that we can do if we work together and come up with some initiative things but I don't want to spend another four hundred million dollars a year for insurance companies we have constituents that can't even get to see a doctor. They cannot get in to see a doctor there's none out there. Because we have such beautiful reimbursement rates I'm asking you to say no let's fix it let's do it right we have time we can do it but if we vote yes and pass it will be the same thing And waste tax dollars for nothing so I'm urging you to say no this doesn't have to be the end we don't shut down the rural hospitals we can add some money to it and you're going to hear we can't do it will cost more money but you know what it's time we fix it and so I'm pleading with yelp vote no on this let's do the right thing thank you. President Bentley spoke against the bill we would like to speak for the bill. Would anyone like to speak against the bill. President gray you're recognized close for the bill. Thank you Mr Speaker has back there taking notes and. So it to me to representative Bentley's point about. People in these Q. H. P.'s a qualified health plans having better insurance than the Medicaid population I'm not going to disagree with that I can't currently our Medicaid population they get twelve visits a year that's doctor and chiropractor in specialised altogether we're working this session several legislators to try and get that expanded they only a five hundred dollars a year in lab and X. ray we're working Senator Irvin I in her name and she's Bills amendment on it have a bill do double that and I think Senator John R. yes I've already called you senator representative Johnson has a bill to expand the number of prescriptions that are in Medicaid so I tell you this this is different it always has been but we recognize that there are issues with Medicaid and we're working to address those this session currently and and also want to say that about a third of the people that are in fee for service Medicaid or what we call dual eligible so their Medicare and Medicaid so they do have Medicare firsthand Medicaid picks up the co insurance the twenty percent less five have left by Medicare. One thing that I will I guess kind of stand corrected on and I was talking about the two states Oklahoma and Missouri you a ballot initiatives to expand Medicaid I'm told that Missouri has not actually implemented there's yet so just let you come to correct that as well. One of the other things that I wanted to talk about today was. The representative Miller's point I know he has a bill out there that set him what he wants to do is if we don't pass this and he ran it last session Pending till under still the economics around that I was supportive of what he was trying to date he has a bill that says he wants to not pass this and then passed straight fee for service Medicaid so keep everybody expanded up to a hundred thirty eight percent of poverty level but let's put it back in that bad insurance back in the Medicaid that doesn't cover everybody as well. And I keep hearing that that's going to save the state money will it does in one pot okay so we we because reimbursements are so low and we pay on an as needed basis. We spend less state general revenue. But we will lose more in general revenue that's generated through sales and through state and local taxes than what we say so state wide state wise we do it we lose money going to fee for service Medicaid. As a taxpayer does this cost us more in the end yes it does because federally we get more federal funds and so you know I hear the argument we ought to taxpayer I don't want to I don't want to take those federal monies well let me tell you something. I was has started a clinic back in two thousand eleven I think it was when right before all this started I was caught in in order to pay for the affordable Care Act Medicare cut their rates across the board for everybody uncompensated care for hospitals that the that the fans used to reimburse that went away okay so what the feds did it says here we're going to take away some of your reimbursement you want it back you're going to play ball and that's what we did back in two thousand thirteen so yes is there more federal money coming into the state yes there is but I would say that we were getting that money prior to two thousand thirteen so we're just taking back what we already were given before and one of the other things that I wanted to bring up in my closing. I did a whole bunch of work here and so fee for service they're only. What I could find was about five states in the country actually use fee for service Medicaid for their populations anymore the rescue something called managed care organizations so if we were to not do this and we went to fee for service more than likely we'd end up in a managed care situation you've heard of ten care that's a managed care tennis that's Tennessee's option for it. The difference between Medicaid managed care and what we have is the reimbursement rates so the managed care companies have to pay they have to follow the same reimbursement rates that Medicaid does so an office visit where Medicaid would normally pay used to be thirty six dollars and thirty cents. A Medicaid managed care company is obligated they can only spend thirty six thirty but they've got to make some money out of it too so they're going to pay the doctor's office twenty eight they're going to keep the difference so the reimbursement rates to providers and hospitals will actually be even less through managed care so those are the options if we don't do this I've also heard that and there's some discussion about it but according to DHS and their attorneys if we don't pass this we revert back to the seventeen percent we don't stay expanded that would take a whole nother bill. The whole nother program to continuous on. One thing I found interesting hand after I ran this in the house I asked BLR and some others to do some research for me. Disability claims in the State of Arkansas I want to know what what or disability claims look like okay so starting back in two thousand ten. Our SSI disability has occurred it decreased in the last ten years by thirty percent it's gone down from forty seven thousand and sixty three applications a year to thirty three thousand two hundred and thirty. The number of employed or Kansas has written to record reason to record highs and both as a raw number end as a percentage of population. He in two thousand thirteen sixty six point six percent of our Kansans were employed by two thousand nineteen this percentage had grown to seventy point six now I'm not naive enough to say well that's just because of expanded Medicaid but I think that that had something to do with that we had something for these people it was a crutch right it helps them. Move up the ladder. The average churn for people in expanded Medicaid is two and a half years so it's not something that we're putting people on in their stay in five six seven years it's a tool for them to better themselves and have health care coverage and have one less thing to worry about what they're going to school while they're getting training while they're looking for that job. What I get all worked up about healthcare policies I think I'm done with my closing now and and I think we did that in record time Hendren like twenty minutes so thank you all for listening and I appreciate a good vote thank you. Represent gray his clothes for the bill. Question before the House is the passage of Senate bill fourteen prepared machine Mr Clerk. Everyone voted. As everyone voted. Cast about Mr Clark. By a vote of sixty four Yeas thirty four Nays and one present the Bill pass. Represent represent wing for what purpose. Motion. Let's hear your motion okay. I move suspension of rule six B. of the twenty twenty one regular session house of representative rules for committee procedures and section two AA of the emergency rules for the house of representatives for the conduct of business in the house chamber during the twenty twenty one regular session regarding the mask requirements and House committee rooms public comment holding rooms and House properties for the remainder of the twenty twenty one regular session. That's proper motion it is debatable you're recognized to explain The motion. Thank you Mr Speaker this motion just matches what has already taken place in the Senate this afternoon in which would allow us starting on April first not as an April fools joke but to be able to wear the masks if you want to and not if you don't. Purpose of winning his ex. Represent Dotson for what purpose question. You're recognized. Thank you Mr Speaker does that also include the plexiglass or. What is what is done with that this does not really address the plexiglass but it is a definite step in that direction. Represent Springer for what purpose question you're recognized is this in compliance with the federal CDC guidelines for the mass to be removed do you have any authority from anyone there this is in the direction of what is taking place in the state of Arkansas with the governor's mandate being released and also are we have already consulted with the department of health as well and and follow us and share what for the hot Department of Health say department of health said that this is okay they they and the Department of Health. Jondo hi. Yeah I don't know yeah I have a problem with this thank you Mr. Represent McCollum for what purpose question you're recognized. Why are you doing this. We're doing this because the mask mandate is going to be lifted or we're going to follow compliance with that. And also the Senate also has done this as well so it'll be consistent within both houses of the legislature. Thank you. Represent wing is explained the motion we would like to speak against the motion. President Crawford you're recognized to speak against the motion. Thank you Mr Speaker I want to be free DO want to be free it's time to get rid of the mask so I would ask you to vote against this. The governor just ended the mass mandate today. It just kind now. Oh did I hear it wrong I just got my hearing aids sorry. You said April one. Excuse me we are free thank you. Representative represent Crawford his. Smoking against for. We would like to speak for the motion. Would anyone like to speak against the motion. Person wing would you like to you're closed the question before the House. It's a suspension of the rules as set forth in representive wings motion all in favor say aye. Any opposed. The ayes have it. Send Meeks for what purpose motion please to your motion after the announcmenet trading of the bills transferring the bill's place in the calendars on the desk members amending their own bills their own amendments members withdrawing their own bills finalize resolutions reading communications and any remaining committee reports I move we adjourn until one o'clock tomorrow afternoon. That's a proper motion. It's not debatable. All in favor say aye. Any opposed. The eyes have it are there any announcements representative Jett for what purpose announcmenet you're recognized revenue tax makes it to fifteen one fifty one represent Ladyman for what purpose announcmenet you're recognized public health will meet at two fifteen AM maxi. President Lowery for purpose announcmenet you're recognized House insurance and commerce will meet at nine thirty tomorrow morning in conference room C. represent wing for what purpose announcmenet. House Management will meet tomorrow morning at eleven AM and mac B. that's tomorrow morning back B. I will also be taking a photo at that time as well represent all before purpose announcmenet recognized judiciary will meet at two fifteen Matt K. Ferguson of each what purpose management you're recognized the house rules committee tomorrow twelve noon big might be present Tosh for what purpose announcmenet you're recognized state agencies nine thirty in the morning room one fifty one represent Vaught what purpose to announcmenet you're recognized sorry ACT will meet tomorrow at two and we have per caucus in the morning at seven AM. Any other announcements. That's warming open is need for the reading of bills and upon completion The Addams named in the joint resolution house to be