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LITTLE ROCK, Ark. (KTHV) --Much of the federal health care law will kick in 2014, but there's a group of Arkansans who are not covered now and still may not be under the new laws.

The state will take up the issue of expanding Medicaid to cover low-income workers. If it doesn't happen, 250,000 Arkansans won't be able to apply for subsidies or receive Medicaid.

Senator David Sanders isn't outright opposed to Medicaid expansion, but is still hesitant.

"A lot of lawmakers aren't clamoring to add 250,000 Arkansans onto the roll. Today, the system is broken," said Sen. David Sanders, R - Little Rock.

The group of 250,000 is living at 100 percent of the federal poverty level. That equals to $23,000 for a family of four. Governor Beebe and the Department of Human Services want to expand Medicaid to cover them, which would put a full third of the state population on Medicaid, but Sanders has some questions before diving in.

"Can we narrowly tailor a program that makes more sense to Arkansans than some of the other states?," wondered Sanders.

Amy Webb with the Department of Human Services says it would actually save the state $115M the first year because the federal government will foot the bill and it will make for a healthier population.

"We have hundreds of thousands who are uninsured. Getting them access to health care would make them healthier," said Webb. "We know expansion will help rural and local hospitals and deal with uncompensated care."

If Medicaid is expanded, by 2020 Arkansas would be responsible for 10 percent of the costs. Sanders says that equals to $100 M a year.

"We do know medical costs escalate. What is projected today may not be reality in the future," said Sen. David Sanders.

The income bracket this group is in would make them ineligible for federal subsidies for the future health care exchange program. If Medicaid is not expanded, we will still have 250,000 without health care just like right now.

The issue gets more complicated because of a $138 M projected shortfall in the Medicaid budget. Sanders says he wants that addressed before expanding the program. Webb says DHS already has programs it's willing to cut in order to meet the budget.

The federal government says it will pay for 100 percent of Medicaid expansion for three years starting in 2014. Between 2017 and 2020, it will gradually be reduced, so the state will eventually be responsible for 10 percent. Currently, the ratio is 70 percent federal and 30 percent state.

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