Gov. Asa Hutchinson will include only two items in his special session call: a bill creating Arkansas Works, and a bill creating a managed care system for some Medicaid programs, his office said Tuesday.
The decision means a bill competing with the managed care bill and supported by some legislators will not be on the call list.
Hutchinson is calling legislators into a health care special session April 6 to consider those issues, to be followed April 13 by a fiscal session, which occurs every even-numbered year.
The Arkansas Works legislation would create the successor to the private option, which uses federal Medicaid dollars under the Affordable Care Act, otherwise known as Obamacare, to purchase private health insurance for adults with incomes up to 138% of the federal poverty level. Created in 2013, it now covers more than 200,000 individuals and has reduced uncompensated care provided by hospitals, but critics say it is an unsustainable expansion of Obamacare.
Hutchinson also is supporting a second bill, the Arkansas Medicaid Reform Act of 2016, that would create a managed care system in Medicaid for individuals with developmental disabilities, those receiving behavioral health services, and all dental services. In that model, a private company or companies would manage those parts of the Medicaid program under contract with the Department of Human Services, receiving a set amount per member. Vendors would make higher profits for cost-efficient care while bearing the financial burden if they to meet targets. The Stephen Group, a consultant advising legislators on the Health Reform Legislative Task Force, has said the model would save the state $1.4 billion from fiscal year 2017 to fiscal year 2021.
‘A VERY SHORT SESSION’
Hutchinson chose to leave off the call a bill that would compete with his managed care bill. In that version, known as DiamondCare, the state would contract with a private administrative services organization to manage programs for developmentally disabled and behavioral health populations, with expected deliverables regarding patient outcomes and savings. The Stephen Group said that model would save $1.1 billion from 2017-21.
Hutchinson can determine the specificity of what is on the call list. Earlier Tuesday (March 29), he told reporters he wanted the session to be focused on the two bills he supports.
“I will continue to work with the legislative leaders but intend to have a very short session and cover the important issue of Arkansas Works, which is critical, as well as the savings plan,” he said. “I will continue to work with them with the specific bills to be designated before the call, but I will anticipate it being very close to what we have offered and put out there right now, which is the savings plan as well as the Arkansas Works.”
DiamondCare has been supported by some legislators on the Health Reform Legislative Task Force, which has been meeting the past year to consider health care issues.
Rep. Michelle Gray, R-Melbourne, is one of the lead sponsors of that bill, which is still in draft form. She said today that her group will continue to draft the bill and have it ready for the session in case it can be fit into the call list or in case the governor’s plan fails and he decides he needs another savings model. In a special session, other items can be added with a two-thirds vote of the Legislature. Gray said her group would consider using that route.
As for the governor’s decision, Gray said she was disappointed.
“We’ve been working, the task force, all 16 members, for almost a year,” she said. “We’ve put in a lot of time and effort and research and a lot of heart into looking for real reforms to help the governor achieve his savings goal.”
To be enacted during the special session, Arkansas Works and the managed care model require only a majority vote. However, funding will require support from three-fourths of the Legislature during the following fiscal session – a much higher hurdle. It takes only 25 House members or nine senators to prevent the program from being funded.
Gray, who is undecided on Arkansas Works, said the governor’s decision will not affect her vote.
“That vote is completely separate, and as a legislator you have to learn to take the emotion out of your vote. … I hope to think that I’m a bigger person than that,” she said.
The task force split on the two savings plans in a vote March 7 and made no recommendation. Eight of the 16 members voted for a managed care concept while seven voted for a concept similar to DiamondCare. The task force’s chairman, Sen. Jim Hendren, R-Gravette, said after a task force meeting Tuesday, but before Hutchinson’s announcement, that the DiamondCare bill “certainly needs to be considered” and that he hopes “that there’s some ability for those two methods to get together.”
However, he said the call list is the governor’s prerogative and that Hutchinson’s predecessor, Gov. Mike Beebe, didn’t issue calls for special sessions until bills were written and roll calls had been tallied.
During the task force meeting, Sen. Keith Ingram, D-West Memphis, expressed frustration with the possibility that the DiamondCare bill might not be considered.
“I have not seen any negotiating from the governor’s office in including any of the DiamondCare, but I’ll go on record,” he said. “I think the governor’s making a terrible mistake with the Legislature. … If he is going to put us all through this and had his mind made up that it’s going to be managed care, then this is an exercise in total futility.”