By JOHN HOFHEIMER
Leader senior staff writer
“Nobody doesn’t like Sara Lee,” and it was hard to find any lawmaker who didn’t like Asa Hutchinson on Friday, after the new governor said he wants to fund private option through 2016 while convening a legislative task force to help restructure Arkansas Medicaid.
That universal support on the divisive issue of private option may signal that, like the parable about the six blind men and the elephant, everyone brought their subjective interpretation to the governor’s speech and took away a unique understanding.
“I was pleasantly surprised,” said state Rep. David Hillman (D-Almyra). “I think there will be some tweaks to what we’ve got — some minor modifications to (the private option law) we passed two years ago. By the time new appropriations run out Dec. 31, 2016, we’ll have a good handle on if it’s working as we want, and we’ll know about modifications by the new Congress.”
But Donnie Copeland (R-Little Rock) says those currently on private option need to start making plans now because, by Jan. 1, 2017, private option will be history.
“We need to make sure the 210,000 people are no longer on Medicaid,” he said.
Copeland, who said, “I loved 95 percent of what (Hutchinson) had to say,” intends to introduce a bill to send letters out to those recipients so they know the government won’t be helping any but the disabled and others unable to fend for themselves.
“That is fair to me, to let them know the program is going away,” Copeland said. “Most ought to be able to get quality care at a fair price.”
Copeland said his goal was to cover people who can’t work. “I want my tax dollars to go to help them, not the healthy people with no impediment to work.”
In support of the governor’s plan, Sen. Majority Leader Jim Hendren (R-Gravette) on Thursday filed SB96, “The Arkansas Health Reform Act of 2015,” which would create at 16-member task force to find innovative reforms.
Area lawmakers could play a large role in drafting those recommendations. Both Senate President Pro tempore Jonathan Dismang (R-Searcy) and House Speaker Jeremy Gillam (R-Judsonia) will be on the task force and each will appoint six other members.
Both have supported private option in the past, and Dismang was an architect of it.
In addition, Hendren, as Senate majority leader, and Keith Ingram (D-West Memphis) Senate minority leader, will be on the task force.
House Majority Leader Ken Bragg (R-Sheridan) and Minority Leader Eddie Armstrong (D-North Little Rock) would also be on the task force.
“I feel good about (the prospects of) both,” Dismang said Friday morning about SB96 and funding for private option.
The Arkansas Health Reform Act of 2015 requires only a simple majority of both houses to pass, but reauthorization of private option would require a super majority — 75 percent of each house, he said.
Dismang said he hadn’t polled the membership yet on SB96, and he wasn’t sure if the formal introduction would be in the senate or the house.
“The goal will be to start the process, hopefully, Monday morning,” he said.
Rep. Joe Farrer (R-Austin) was a staunch opponent of private option two years ago. On Friday, he said he’d vote to reauthorize it through 2016 while the task force works to realign Arkansas healthcare.
“To me, it ends the private option the way it should be ended. It doesn’t kick everyone off. We’ll come up with a plan that meets Arkansas’ needs.
“This gives us a task force to fix the plan,” he said. “You can’t put another system on top of a broken one and make it work.
“I’m pushing to get on the task force,” he said.
Sen. Eddie Joe Williams (R-Cabot) said, “We need to do what’s best for entire state. We agreed when we went down this road to look at the data. Uninsured care is down. Hospital reimbursements are up.”
Through 2021, the federal government is picking up 100 percent of the tab, he said, other than some administrative costs. “We need to make recipients more responsible,” he said, and provide preventative care.
He said private option has “better chances today than 30 days ago,” noting that Hendren, who introduced the health reform bill, was a big opponent of private option last year.
Williams predicted a short session, with two signature pieces of legislation proposed by the governor — his $100 million middle-class tax cut and his health-care reform bill — both well on the way.
“I was very pleased at the tone he took,” said Rep. Doug House (R-North Little Rock). “The governor said, ‘I fought it and lost,’ but all the Republicans and half the Democrats hate Obamacare. I’m pleased he wants to take a look at the whole thing. My vote has always been for keeping hospitals open. I’m confident our bill will pass.”
House said he’d like to see block grants to the states with a lot of flexibility. “It’s easier to fund private clinics directly to provide the necessary care,” he said, than to work through private insurance companies.
Rep. Bob Johnson (D-Jacksonville) said the governor was staying level-headed and making sure that “if we quit the program, there’s an alternative that’s good for those on private option. The voices I hear say private option and tax cuts both are going to pass.”
Rep. Karilyn Brown (R-Sherwood) said, “I think his approach was rather measured. Even people who don’t support Affordable Care and private option know you just can’t go around pulling the rug out from under people.”
She said lawmakers need some time to work out an affordable solution. “We have some smart people in the legislature, and I feel confident that we’ll come up with something good.”
Brown said she was pleased that Health and Human Services Secretary Sylvia M. Burwell’s letter seemed to support the governor’s goals.
Rep. Camille Bennett (D-Lonoke) said, “I think he did an excellent job of walking us through the problem.
“I’m really encouraged,” she said. “I kept waiting for the other shoe to drop. He did a real good job of…highlighting the desperate need to help people who were uninsured. It was the right thing to do. He repeatedly talked about our duty.”
Rep. Tim Lemons (R-Cabot) said, “I’m still in the process of reviewing the speech.”
In his speech to a packed auditorium at the University of Arkansas for Medical Sciences, Hutchinson said the private option solution to Medicaid expansion was innovative, but that it had divided the state and dominated the political debate.
“Hear me clearly,” Hutchinson said. “We’re going to continue the private option through 2016 and create a Health Reform Task Force that will make recommendations for the future. It should explore options to modernize the entire Medicaid program currently serving the indigent, aged and disabled. It should minimize or eliminate the need to raise additional revenues for that purpose.”
He said he had two nephews in the General Assembly, both thoughtful conservatives, and that one voted for private option and one against.
The governor said private option has benefited about 210,000 Arkansans, most of whom had been uninsured, as well as urban hospitals, such as UAMS, and rural hospitals.
Hospital visits by uninsured patients fell by 47 percent, he said.
When the state becomes responsible for 10 percent of the costs in 2021, that will amount to about $200 million a year.
“Do the benefits that we recognize exist outweigh the costs,” Hutchinson asked, saying the question caused a political divide and wrapped the state around a political axle.
“The phrase ‘private option’ itself has become politically toxic,” he said. “The goal is to have affordable, competitive, market-based solutions on the conservative principles of choice, competition, improved quality of care and consumer responsibility.
“In 2015, the state is going to save roughly $88 million, which is a combination of shifting traditional Medicaid in some categories to the private option, which is 100 percent paid for at the present time. It is also a savings because the reduction of uncompensated care payments to several agencies — from UAMS to the Department of Correction, the Department of Health, Community Health Centers — have saved the state about $33 million,” Hutchinson said.
“I want our social programs in Arkansas to be an incentive for people to work,” he said. “Arkansans want to work, and, when they work, they should get ahead. And, when they work real hard, they should climb up the economic ladder.”
He called for incentives for preventive care. “People need to own more responsibility for their health-care decisions. We need the emphasize the role of the private sector and charity care.”
He called for development of telemedicine to increase the quality of health care in rural areas.
He said the insured, the hospitals and health-care providers cannot face a traumatic cliff every year when it comes to renewing private option. “We need more consistency. We need more reliability. We need more predictability. So we can plan.
“I want to assure…all Arkansans that I want us to have a system that is compassionate, affordable, fits Arkansas and provides access to care.”
He wants more flexibility, including the authority for block-grant type waivers.
He wants to strengthen the employer-sponsored health- insurance market and increase employment of healthy recipients of healthcare services.
Hutchinson would also like to provide access to health services in rural areas.
He wants a report from the task force by the end of 2015 and to have solutions in place by Dec. 31, 2016, when private option would expire.
The governor also said he was encouraged by a letter of support for many of his goals from the secretary of Health and Human Services.
