Arkansas Medicaid 'Private Option' Funding Bill Passes Legislature After Clarifications

Apr 18, 2013

Senators Jonathan Dismang (R-Beebe), David Sanders (R-Little Rock) and Missy Irvin (R-Mountain View) present amendments to SB 1020 in House committee Wednesday afternoon. Bills and appropriations for the so called private option of Medicaid expansion passed the Arkansas legislature Wednesday.
Credit Nathan Vandiver / KUAR

Arkansas will await federal approval of a plan to provide private health insurance to roughly 250,000 of the state’s working poor with federal money after the state Senate approved a bill allowing the plan to be funded Wednesday night.

Arkansas lawmakers put in a long day filled with many procedural moves in order to pass a funding bill for the state’s private option plan of Medicaid expansion under the Affordable Care Act. The biggest hurdle to the plan was getting the necessary 75 percent majority in both chambers for its funding appropriation and that was what drove the procedural efforts to amend the bills.

Lawmakers had to expunge votes from private option enabling legislation already on the Governor’s desk to amend the bills to provide more clarity about how they will be approved by the federal government and to say the plan would prevent small businesses in the state from paying a fee associated with the Affordable Care Act.

It was a complicated process lawmakers would go through for the better part of the day in order to get one more vote in the Senate to pass the plan’s funding appropriation.

It was a lot of work, but as Representative John Burris, R-Harrison, and sponsor of the private option bill that originated in the House, quipped to colleagues on the House floor, there was something in it for everyone.

“We need to expunge the vote, this requires two-thirds vote, I guess the easiest way to say it is if you’re for the bill this is a process that’s going to make it a better bill, if you are against the bill, go ahead to expunge the vote so you can try to kill it one more time,” Burris said.

It turned out the amendments gave Senator Missy Irvin, R-Mountain View, the reassurance to vote for the plan by providing more clarity regarding the way the plan would be carried out.

“That is a huge component for me,” Irvin said. “It’s also a huge component for me that it explicitly states that this establishment of this program – that these employers will not be subject to these penalties, and that goes to the idea of creating jobs in the state of Arkansas and that goes to the protection that I think is needed and that needs to be codified in the statute.”

With those amendments the Senate moved forward with its vote on the plan’s appropriation in front of public galleries that were still crowded at 7 p.m.

Senator Jonathan Dismang, R-Beebe and sponsor of the enabling legislation that began in the Senate, told his colleagues the funding bill was written broadly enough that even though the enabling bill was amended, it did not also need to be changed.

Sen. Jim Hendren (R-Gravette) asked his colleagues not to vote for the private option plan saying it would contribute to the national debt.
Credit Nathan Vandiver / KUAR

Speaking against the appropriation, Senator Jim Hendren, R-Gravette, echoed arguments brought against the plan in the House: that it would contribute to the national debt.

“I ask you to vote against this, not because I don’t think that folks have made a bad problem better, I ask you to vote against this not because I don’t care about those in need,” Hendren said. “I ask you to vote against this because we can’t continue to spend our grandkids inheritance and future.”

Following Senator Hendren, Senator Hutchinson, R-Benton, spoke for the plan and its appropriation calling it a one time chance for reform.

“The only way we’re ever going to reign in the size of government is to have a chance to reform the entitlement programs, and our entitlement programs – and Medicaid included – have every wrong incentive you can imagine and encourage abuse and encourage bad behavior,” Hutchinson said. “I’m afraid to say we have one window, one opportunity, to reform it, and it’s right now.”

The Senate passed the appropriation with 28 yeas to 7 nays. The plan’s supporters had worked all day to get just one more vote, but in the end got two having started the day with an expected 26 yeas, the appropriation needing 27.

Following that vote the Senate re-approved the private option’s enabling legislation with amendments, as did the House.

Governor Mike Beebe spoke to reporters after the vote saying it was an example of bipartisan lawmaking that should send a message to the rest of the country.

Gov. Mike Beebe told reporters after the Senate passed the private option appropriation that the state is serving as a model for the rest of the country.
Credit Nathan Vandiver / KUAR

“If there’s a message it’s Republicans and Democrats without regard to their party labels can figure out what’s in the best interest of their people and go solve a problem and do something for the benefit of their constituents and that’s really what this is all about,” Beebe said.

The rest of the country has been watching the development of Arkansas’s plan to take advantage of the federal money available through the Affordable Care Act for Medicaid expansion. Now approval is needed from the US Department of Health and Human Services, which will have the final say on the plan.