Friday, November 16, 2012

Is a health exchange back on for Arkansas?

Posted By on Fri, Nov 16, 2012 at 12:19 PM

The Obama administration announced late Thursday that it would extend until Dec. 14 the deadline for states to say whether they'd like to run their own health insurance exchanges under the federal health care law. The deadline had been today.

The question: Does that open a window for Arkansas?

Republican-run states and legislatures had opposed joining the exchanges - intended as markets for insurance - as part of massive resistance to the federal Affordable Care Act. With the law upheld by the U.S. Supreme Court and Obama re-elected, Republican leaders around the country have begun reconsidering whether to participate, but still complained about the Nov. 16 deadline.

In Arkansas, Republican opposition led Gov. Mike Beebe to decide not to buck the will of the legislature. Rather than opt for a state-run exchange, Beebe opted for a partnership with the federal government and sent a letter yesterday notifying the federal Department of Health and Human Services of that decision. The letter was sent before the deadline was extended. That changes the situation, said Beebe spokesman Matt DeCample: "We are going to call HHS and advise them that if things change in Arkansas and there is legislative support for state exchange before the deadline, we may amend the letter."

Republicans previously had been adamant, DeCample noted. "If that has changed, we want to leave that door open. If not, we've already got the letter for the partnership and at least we will have some state input."

I first became aware of this from a Twitter last night by Rep. John Burris, the Republican leader during the last legislature. He noted the deadline delay to make a point Republicans had made during the session: Beebe's pressure for a decision on exchanges, and enabling legislation to run one, were premature.

Burris said Beebe warned of a deadline that didn't exist then and that ultimately proved changeable. What about now? "At this point, I think it's just really difficult to rely on any information we get from them."

Nonethless he said it was "absolutely" worth having further discussions on the issue of a state-run exchange. He said there was probably still "unanimous" hesitancy on the part of Republicans to move forward. But he added: "I think we can have the discussion. It is the law. It's not going to be repealed and we've got to make it work somehow."

Burris emphasized that the Beebe administration had poisoned the discussion by "jumping the gun" and doing it "for political reasons" by pushing for approval of a health exchange before the deadline.

Beebe could note to Health and Human Services the possibility of a state exchange and attempt to pass enabling legislation in January. If the effort failed, the state could proceed as planned. Burris said even if Arkansas opted to run its own insurance market, Republicans had objections to how Insurance Commissioner Jay Bradford proposed to run it.

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