Flanked by several colleagues Tuesday afternoon, Rep. Bob Johnson, D-Morrilton, said at least 30 representatives already support his proposal, and he expects to gain more adherents by the end of the week. Three-quarters of each chamber of the Legislature must approve a spending package for it to pass. Two spending schemes are on the table. House Minority Leader Jim Hendren, R-Sulphur Springs, is to present a third plan in the Capitol rotunda today. In December, Huckabee threw his support behind the spending plan developed by Coalition for a Healthy Arkansas Today -- a group of more than 100 health-care organizations across the state -- the state Department of Health and the University of Arkansas for Medical Sciences. "We're hearing from coalition people publicly that they're supporting the coalition, but privately, they're saying, 'We really like your plan better. We feel like it serves more people across the state,' " said Rep. Randy Laverty, D-Jasper, who was with Johnson on Tuesday. Members of the coalition said they were surprised by Johnson's announcement, since House leaders did not contact them as they were drafting the proposal. "The speaker is going against all of the health and health-care organizations in the state," said Dr. Joe Thompson, a pediatrician who has presented the coalition's plan to lawmakers. Under Johnson's plan, 42 percent of Arkansas' $1.6 billion share would go toward expanding Medicaid. With federal matching grants, House leaders expect the total to be about $85.2 million per year. The coalition's proposal, by comparison, would dedicate 27 percent to expanding Medicaid. The next-largest portion under Johnson's plan, 22 percent, would be distributed to local hospitals in the form of grants and loans; community groups that work to improve the health of Arkansans; an Area Health Education Center in the Mississippi Delta; and the Meals on Wheels program. The coalition's proposal does not allocate money directly to local hospitals Instead it creates an Arkansas School of Public Health and funds health initiatives for members of minority groups and the Donald W. Reynolds Center on Aging. Johnson's plan would allot 20 percent to smoking prevention and education programs, while the coalition's proposal would allocate 29 percent in this area and create a marketing campaign recommended by the national Centers for Disease Control and Prevention. Fifteen percent under Johnson's plan would be dedicated to a trust fund, compared with 8 percent in the coalition's plan. Johnson's proposal would also use 1 percent of the payments to evaluate expenditure of the money. The coalition's plan, by contrast, would use trust fund proceeds to monitor programs. Finally, Johnson's plan would immediately designate for medical research any annual funds in excess of $55 million, the estimate of annual payments used by House leaders in drafting the proposal. If the annual payments are not larger than $55 million, research would not be funded until 2011, when the trust fund principal is expected to reach $300 million. The coalition's proposal would devote 21 percent of the money toward research, establishing the Arkansas Biosciences Institute. Johnson said his proposal is superior to the coalition's in several respects. It was developed by representatives after they solicited constituents' opinions through meetings and clip-out questionnaires printed in newspapers, he said. It would support local hospitals, and it seeks to improve health care by steering the funds toward community-based groups. Lastly, he said, it would protect Arkansas' share of the tobacco settlement by investing a larger portion in the trust fund. "We don't start robbing from our trust from Day One. The coalition's plan does," Johnson said. "That's not a trust fund. It's a checking account." But a Huckabee aide and members of the coalition said they were skeptical, primarily because Johnson's plan does not dedicate enough money to smoking prevention, research and public health education. They also expressed concern because, they said, the speaker's proposal was not based on evidence about other successful programs. "The [Coalition's] plan has been developed over weeks and weeks and weeks of intense research and study," said Dr. Gary Wheeler, a member of the Coalition for a Healthy Arkansas Today. "We don't know what evidence-based sources [Johnson] has used for the development of his plan." "We're not at all opposed to local communities developing their own goals, but they're going to need to conform to certain standards in order to be effective," Wheeler added. "It's by taking advantage of our best research resources in the state that we will improve the health of Arkansas."

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