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The Arkansas private option could be in trouble
A minority of state legislators may put health coverage for 100,000 Arkansans in jeopardy.
Here we go again.
Last year, the news in Arkansas was dominated by months of tense debate over health care reform and a major decision for the state. With key provisions of the federal Affordable Care Act set to go into effect in 2014, should the state accept billions of dollars of federal money in order to expand eligibility for the Medicaid program for low-income Arkansans?
Given the strong anti-Obamacare tenor of a campaign that swept in a new Republican majority in the Arkansas General Assembly, the prospects for expansion seemed dicey, if not impossible.
The drama took an unexpected turn in late February when the feds gave the state permission to pursue a unique approach, which became known as the "private option." Arkansas would use Medicaid funds to purchase private health-insurance plans for low-income residents. Republicans took ownership of the new plan, and after a protracted battle at the Capitol, it eventually passed with a bipartisan supermajority in both houses, with Gov. Mike Beebe signing it into law in April.
For Republican backers of the plan like Sen. David Sanders (R-Little Rock), the private option is "innovative, pioneering and transformative." The idea of a conservative version of Medicaid expansion received national attention as well; in recent testimony before the legislature, former Bush administration Health Secretary Michael Leavitt applauded the effort underway: "You couldn't get the federal government to do this countrywide. But you can do it in Arkansas. And when you do, others will follow." But for some conservatives, the plan was a betrayal, relying on an increase in government spending granted by the hated Obamacare. The split within the Republican Party in Arkansas (what Rep. Joe Farrer [R-Austin] calls "the conservatives and the real conservatives") remains raw.
Coverage under the private option just started on Jan. 1, and — even as enrollment in the new marketplaces created by the federal ACA has faced massive hiccups — the implementation of the private option in Arkansas has been going as well as proponents could have hoped, with around 100,000 gaining coverage thus far.
Just as the private option is getting off the ground, its future appears to be in serious jeopardy in the fiscal session of the General Assembly, which begins Feb. 10. In order to continue the policy past the end of the fiscal year this summer, three-fourths of both houses of the legislature must once again approve the appropriation to accept the federal money that funds it. The rump group of Republicans who opposed the policy are gearing up for another fight, and the path to another supermajority is uncertain at best. Rep. Nate Bell (R-Mena), who opposes the private option, said that there was "no question" that as of now, there are enough votes to block the funding. "I think anybody in the Capitol building would agree with that," he said.
A minority of state legislators may put health coverage for 100,000 Arkansans in jeopardy.
Here we go again.
Last year, the news in Arkansas was dominated by months of tense debate over health care reform and a major decision for the state. With key provisions of the federal Affordable Care Act set to go into effect in 2014, should the state accept billions of dollars of federal money in order to expand eligibility for the Medicaid program for low-income Arkansans?
Given the strong anti-Obamacare tenor of a campaign that swept in a new Republican majority in the Arkansas General Assembly, the prospects for expansion seemed dicey, if not impossible.
The drama took an unexpected turn in late February when the feds gave the state permission to pursue a unique approach, which became known as the "private option." Arkansas would use Medicaid funds to purchase private health-insurance plans for low-income residents. Republicans took ownership of the new plan, and after a protracted battle at the Capitol, it eventually passed with a bipartisan supermajority in both houses, with Gov. Mike Beebe signing it into law in April.
For Republican backers of the plan like Sen. David Sanders (R-Little Rock), the private option is "innovative, pioneering and transformative." The idea of a conservative version of Medicaid expansion received national attention as well; in recent testimony before the legislature, former Bush administration Health Secretary Michael Leavitt applauded the effort underway: "You couldn't get the federal government to do this countrywide. But you can do it in Arkansas. And when you do, others will follow." But for some conservatives, the plan was a betrayal, relying on an increase in government spending granted by the hated Obamacare. The split within the Republican Party in Arkansas (what Rep. Joe Farrer [R-Austin] calls "the conservatives and the real conservatives") remains raw.
Coverage under the private option just started on Jan. 1, and — even as enrollment in the new marketplaces created by the federal ACA has faced massive hiccups — the implementation of the private option in Arkansas has been going as well as proponents could have hoped, with around 100,000 gaining coverage thus far.
Just as the private option is getting off the ground, its future appears to be in serious jeopardy in the fiscal session of the General Assembly, which begins Feb. 10. In order to continue the policy past the end of the fiscal year this summer, three-fourths of both houses of the legislature must once again approve the appropriation to accept the federal money that funds it. The rump group of Republicans who opposed the policy are gearing up for another fight, and the path to another supermajority is uncertain at best. Rep. Nate Bell (R-Mena), who opposes the private option, said that there was "no question" that as of now, there are enough votes to block the funding. "I think anybody in the Capitol building would agree with that," he said.
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