Will Tweaks Save Arkansas's Private Option?

Feb 9, 2014

The Arkansas General Assembly is set to convene Monday for a 30 day fiscal session with some big issues on the table. The fate of the private option is in a precarious situation.

At last count the votes are just shy of what's needed to re-authorize the program, which has provided insurance to over 100,000 low-income residents this year. Three state lawmakers took to AETN to discuss the future of the plan.

Republican Senator David Sanders, a key architect of the law, explained why the issue is coming up again less than a year since it barely passed.

“We knew that every single year we would have to re-up, we would have to re-authorize funding for it once again,” said Sanders.

Senate Democratic Minority Leader Keith Ingram expounded on Sanders comments.

“This is a piece of legislation that we can derive best practices from and strive to make it even better session, to session, to session,” said Ingram.

While a majority of lawmakers support the program and the ability to continually change it over time to meet new concerns and needs others like Republican Representative Nate Bell are fundamentally opposed.

“From my standpoint as a consistent deficit hawk, David knows I voted against an eight dollar increase my first term, I don't believe that it's appropriate that I sit here and ask the federal government to send me more money to spend while I complain about what they're doing in Washington,” said Bell.

The program uses expanded eligibility and funds from the Affordable Care Act, intended for the federally run Medicaid program, to purchase private insurance for a projected 250,000 low-income residents. The re-authorization of funds requires a three-fourths vote in each chamber, meaning just 9 senators can thwart the will of 126 legislators.

The plan has so far met and exceeded most projections for cost, demographics, and enrollment but still has lost at least two critical votes.

One supporter, former senator Paul Bookout (D) resigned after revelations of ethics violations. Republican John Cooper, an opponent of the private option, replaced Bookout after winning a special election. Missy Irvin who voted for the funding last year has since changed her mind over concerns about the implementation of health savings accounts and reimbursement rates to specialists.

Some lawmakers, like Ingram, think a few changes could regain supporters.

“We are open to any fresh and new ideas. The thing that is so refreshing is that members of opposite parties are talking about how to fix something and working together,” said Ingram.

Even some opponents like Republican Representative Nate Bell think re-authorizing funds, or at least continuing insurance coverage in some form, is a good idea.

“If we just de-funded this and walked away from those people, frankly I think it's morally wrong to do that to them. We've got to put ourselves in a position where if the private option goes away those folks have a path to continuing to have access to healthcare,” said Bell.

Governor Mike Beebe has been making the case in recent weeks that without the projected $89 million in savings generated by the private option the state's budget would have to undergo intense and rapid changes to remain budget neutral as required by state law.