Thursday, February 5, 2015

Private option passes House and heads to governor

Posted By on Thu, Feb 5, 2015 at 2:59 PM

VICTORY: Speaker Jeremy Gillam after the vote. - BENJI HARDY
  • BENJI HARDY
  • VICTORY: Speaker Jeremy Gillam after the vote.

UPDATE:
By a vote of 80 Yeas, 16 Nos, and 3 present, SB 96 has been approved by the Arkansas House. The private option appropriation passes as well: SB 101 received 82 Yeas, 16 Nos and 1 present. (Two Democrats voted 'present' on the task force legislation, presumably as a protest against the "ending the private option" narrative; Democratic Sen. David Johnson did the same thing last week.)

The private option is renewed and is headed to Gov. Asa Hutchinson's desk.


SB 96
, the bill to create a task force to determine some future direction for the private option, was debated on the House floor this afternoon. Although the appropriation to actually renew funding for the private option was contained in a second bill — SB 101 — it's the task force bill that acted as a proxy for legislative debate over the health care policy.

Rep. Kelly Linck (R-Yellville), who supported the private option in 2014 and 2013 as well, presented SB 96 to the House. As per the points outlined by Gov. Asa Hutchinson in his January speech, Linck said the bill "ends debate over the private option." He emphasized the major (but as yet unknown) reforms that are supposed to be coming to the broader Medicaid in 2017.

"Do we use a hybrid system [like the current private option]? Do we use a different hybrid system? Do we use a block grant, or straight Medicaid? None of those questions are answered in this bill," Linck said. He said the governor had assurances from the federal authorities that HHS would work with Arkansas in the future.

"They said, 'Governor, you come to us, and we'll do what we can to help.' They did not give a green light to everything, but they said they'd work with us."

Former diehard opponents of the P.O.  came forward to speak in favor of SB 96, including Rep. Joe Ferrar and Rep. Bob Ballinger, both of whom were hard "no" votes during the drawn out 2014 battle against the policy.

"It's a compromise bill. ... It gives us a chance to reform a broken Medicaid expansion," Ferrar said of SB 96.

Upon coming to the well, Ballinger made a joke about being struck by lightning: He's fought the private option every step of the way. He said he wasn't happy with everything about SB 96 — "I don't like that there's not a freeze on enrollment. I felt like we could have gotten it" — but said it was the best route to ending the policy.

Some freshmen who campaigned against the private option also came aboard, including Reps. Laurie Rushing (R-Malvern) and Mickey Gates (R-Hot Springs). Rushing, who looked less than certain as she spoke at the well, said "it's the only way to end the private option."

Not every Republican legislator was convinced. Rep. Josh Miller remains staunchly opposed to the private option, and reminded conservative members of the election results last fall. "We didn't make campaign promises to come here and vote to make our colleagues and other elected officials happy. Each of us are here because of the messages we got out in our districts. I'd just ask that we all stay true to what we told our people," he said.

"I am voting no, and I am asking others who have relayed the same message that I have to our constituents to join me. There are other options." 

Conservative freshmen Reps. Brandt Smith, Marcus Richmond and Donnie Copeland also spoke against SB 96, sometimes bitterly.

"We will continue to mortgage the future to put a Band-Aid on this self-inflicted wound," Richmond declared. He pushed back against the we're-actually-ending-the-private-option branding campaign, saying (correctly) that the SB 96 would effectively continue the policy, even though "it will strike forever the words 'private option'" from the state Capitol.

He also said — and also correctly — that if the private option isn't stopped now, it's not likely to be stopped in the future when enrollment increases even further. Currently, over 200,000 Arkansans receive insurance via the private option. "Who will have the courage to stop it when it's between 300,000 and 400,000?" he asked. 

I could say plenty here about the absurdity of framing the withdrawal of health insurance from hundreds of thousands of Arkansans in terms of "courage." But why bother? The battle is over, and AsaCare won.

UPDATE: 

Rich Huddleston, executive director of Arkansas Advocates for Children and Families, has issued this statement about the vote to continue the private option: 

"Arkansas Advocates for Children and Families (AACF) would like to applaud the legislature for backing Gov. Asa Hutchinson’s plan to continue funding for the Private Option. The Private Option provides affordable, quality health coverage to over 220,000 Arkansans. It has also provided financial certainty for our hospitals and the state’s budget.

The Private Option has been a huge success. Beyond improving health – the rate of uninsured adults was cut in half over the last year – the Private Option has been good for hospitals in Arkansas, reducing the cost of treating uninsured patients by over $69 million in just six months.

A legislative task force will determine what shape the Private Option and the broader Medicaid program will take in the future. AACF will work to make sure our lawmakers know how important quality, affordable coverage is for Arkansas families."


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