Friday, February 14, 2014

EDITORIAL >> Let majority save option

The legislature will vote next week on funding the so-called private insurance option, which provides health coverage to some 100,000 Arkansans. Recipients can choose private insurance that’s completely paid for by the federal government.

The program, which is 100 percent funded through Medicaid, passed last year with a 75 percent supermajority. But some previous supporters are wavering and one key Democratic senator has since resigned. His Republican replacement opposes the plan, even though the state would receive nearly $1 billion over the next decade.

Speaker Davy Carter (R-Cabot), who helped craft the private option last year, thinks he’ll get enough votes when the issue goes before the House on Tuesday. He said failure to approve the funding could cost the state $80 million to $100 million in federal funding a year and create a shortfall that would have to be made up at the detriment of other needs, including new prison beds to ease overcrowding.

Sen. Jonathan Dismang (R-Searcy), who pushed the plan through the Senate, is hopeful he’ll get a supermajority again this time. But Sen. Missy Irvin (R-Mountain View), who voted for the private option last time, says she can no longer support the plan. She is said to be unhappy that Arkansas Blue Cross and Blue Shield has cut payments to specialists. Irving is married to a doctor.

But there may be hope that Sen. Jane English (R-North Little Rock), who voted no to the private option the last time, might reconsider her opposition and help advance the plan. After all, three hospitals in or near her district are hoping the private option will bring them more insured patients and reduce uncompensated indigent care.

English was noncommittal when we contacted her earlier this week, but she did say, “This is not an easy thing. There are an awful lot of things to think about.”

Let’s hope she changes her vote to help the uninsured and the hospitals in her district that are struggling to stay open.

Sen. Eddie Joe Williams (R-Cabot) has been a key supporter of the private option. Perhaps he can prevail on a fellow conservative and convince her the private option is the most prudent choice for Arkansas.

Rep. Joe Farrer (R-Austin), who is a physical therapist at North Metro Medical Center in Jacksonville, still hates the private option, even if it means his hospital, which is hanging on by a thread, will close as it continues to write off millions in uncollected debt.

Other area legislators have spoken eloquently in favor of the private option. Reps. Mark Perry (D-Jacksonville), Doug House (R-North Little Rock), Rep. Patti Julian (D-North Little Rock), Rep. Walls McCrary (D-Lonoke) and Rep. Jim Nickles (D-Sherwood), whose political views span the entire political spectrum, all favor the plan. Defeating it would mean budget shortfalls, eliminating tax cuts and laying off state employees.

“I think we crafted, with the Republicans, the best option for Arkansas,” Julian told us recently. “We have 100,000 who have signed up, who are going to have health-care insurance for the first time.”

Julian said she’s worried about how defunding the private option could affect UAMS as well as small and rural hospitals, such as North Metro. “We’ll lose them. We’ll throw people out of work, and we’re going to make health care that much less accessible for people in those communities,” Julian said.

She also said the legislature might have to reinstitute the taxes cut last session to make up the $80 million-$90 million budget deficit that would result from reneging on the private-option promise it made to the working poor last session.

“Education could be hit hard,” Julian concluded.

Rep. Perry insists the private option is not Obamacare. He told us, “I’m thinking it will pass. It is a sensible solution for providing health care for people who need it, instead of expanding the Medicaid roles.”

“I’m just feeling optimistic,” he added. “When you start looking at options, it’s the best available. Other states are wanting to copy what we’ve done. We’re in the forefront of expanding health care instead of Medicaid.”

We’ll give the last word to Rep. House, a former Army lawyer, who says leaders “sometimes make decisions that are unpleasant. That was something I learned in the military.”

He added that 75 percent of the state has spoken and favors the program. “It’s a small minority that is trying to crash it,” House said.

Don’t let that noisy minority dictate state policy.