LITTLE ROCK — A legislative panel on Wednesday endorsed a proposal that seeks to save the so-called private option from political defeat by barring the state from promoting the program.
The Special Language Subcommittee of the Joint Budget Committee endorsed proposed language by Rep. Nate Bell, R-Mena, that would, if incorporated into the budget bills for the state Health, Human Services and Insurance departments, prohibit those agencies from using any appropriated money to advertise or promote the private option or the Arkansas Health Insurance Marketplace. It would not bar promotional activities by private entities such as insurance companies.
The proposed language also would prohibit the agencies from using any appropriated money to fund the activities of the in-person assisters who have been helping people enroll in the marketplace. It would not bar the agencies themselves from providing information in response to inquiries from the public.
The proposal was expected to be taken up by the Joint Budget Committee on Thursday. The House could vote as early as Friday on whether to appropriate renewed federal funding for the private option, Arkansas’ alternative to adding thousands to the Medicaid rolls by using federal Medicaid money to provide private insurance to those making up to 138 percent of the federal poverty level.
Bell told the subcommittee Wednesday that he voted against the private option last year because it is built upon the "flawed foundation" of the federal Affordable Care Act and because he is a "deficit hawk." He said he continues to believe it is bad policy, but that thousands of Arkansans have made life-altering decisions in good faith based on the existence of the private option, and that simply defunding the program would leave many worse off than they were before the program was created, since some were covered under state programs that no longer exist.
"Simply defunding the private option does not reset us to zero," he said.
Bell also said he did not believe the private option had enough votes currently to pass, but that votes also were lacking to pass a budget that did not include a private option.
"That’s an impasse, folks. Do we want to become D.C.?" Bell said.
Rep. John Catlett, D-Rover, asked Bell why the state would not want to inform its people of their insurance options.
"I certainly don’t see the downside at all in not providing people with the opportunity to engage in something that I believe is bad for them," Bell said.
"So you’re saying we should (keep) our people ignorant?" Catlett said.
"No sir, that’s not what I’m saying," Bell said.
Sen. Hank Wilkins, D-Pine Bluff, asked Bell why the state would want to refuse federal funding to help people obtain health insurance. Bell said the federal debt affects Arkansans as much as all other Americans.
The proposed language passed in a voice vote in which several "no" votes were heard.
The subcommittee also approved proposed language by Rep. John Burris, R-Harrison, calling for the state Department of Human Services to request federal waivers allowing it to design a state plan for providing a non-emergency transportation benefit under the private option; to create a program allowing participants in the private option to enroll in health savings accounts; and to impose co-payments and deductibles for participants earning more than 50 percent of the federal poverty level.
The co-payments and deductibles now apply only to people earning more than 100 percent of the federal poverty level.
The language includes a provision stating that if DHS does not secure the waivers by Jan. 1, 2015, the private option will end.
Sen. Jim Hendren, R-Gravette, presented proposed language that would end funding for the private option on Dec. 31. The proposal failed in a voice vote.
Before the subcommittee met, Gov. Mike Beebe told reporters that he had issues with the original version of Bell’s proposal that he saw, but that "the latest drafts are being worked out with our knowledge and consent."
Beebe spokesman Matt DeCample said after the meeting that Beebe was concerned about the provision in Burris’ proposal that would end the private option if additional federal waivers are not obtained by Jan. 1, 2015.
"He worries that that pretty much abdicates the future of the private option to the feds and bases it all on whether or not those waivers occur," DeCample said.
House Speaker Davy Carter, R-Cabot, told reporters he did not know whether the Joint Budget Committee would approve the new language. He said the proposals likely would win some votes and lose some votes.
"There’s a lot of unhappy people right now. But we’ve got to start the dialogue," he said.
Carter, a supporter of the private option, said he could accept the new language but was not willing to make further concessions.
"This is far as I’m going," he said.
House Minority Leader Greg Leding, D-Fayetteville, said he did not immediately know whether House Democrats would be willing to accept the proposals.
"We can’t take the Democratic votes for granted," he said.
Providing a second round of federal funding for the private option needs the support of at least three-fourths of the 100-member House and the 35-member Senate because it is an appropriation bill.
The House appropriated federal funding for the private option last year with two votes to spare. The Senate approved the appropriation with one extra vote, but two members have said they will vote against it this time around — one of them a member who voted for it last year but says she has changed her mind and the other a newly elected member who opposes the private option.
Also Wednesday, the Senate voted 34-0 to approve Senate Bill 1, $2.4 million appropriation bill to cover the Senate’s expenses for the next fiscal year that begins July 1.
The Senate also approved 34-0 House Bill 1001, a $1.1 million appropriation bill to cover the House’s expenses for the fiscal session.
The House voted 78-12 to approve HB 1002, which appropriates funding for the executive and legislative branches. The bill includes a 1 percent cost-of-living adjustment for constitutional officers, judges and prosecutors but not for legislators.