LITTLE ROCK – The proposed insurance rate increases for Arkansas’ exchange and the announcement that the state’s hybrid Medicaid expansion’s enrollment has topped more than 300,000 may complicate the debate next year over the future of the expanded coverage.
With a presidential election looming that could decide whether the health care law that led to Arkansas’ program survives, Arkansas lawmakers are warily eyeing the rate increases and enrollment figures as they prepare for next year’s session.
The state Insurance Department earlier this month said the three companies offering plans on the state’s exchange lowered their proposed rate increases for the coming year. The largest, Arkansas Blue Cross and Blue Shield cut its proposal from 14.7 percent to 9.7 percent. Plan premiums will increase an average of about 9.1 and are below what the companies requested, the department has said.
Insurance Commissioner Allen Kerr warned lawmakers that though the increases are lower than what other states are seeing, Arkansas could be in line for more dramatic hikes if “course corrections” aren’t made.
That warning was followed by the news that enrollment in the state’s hybrid Medicaid expansion is at more than 307,000, topping the 250,000 estimate state officials initially gave on who would be eligible.
The figures come as Arkansas awaits word on whether it can move forward with new restrictions supporters say will make the program more efficient, and it follows studies advocates are trumpeting showing the expanded coverage dramatically cutting Arkansas’ uninsured rate. But opponents of the program already indicate they’re going to use the numbers for another push to end the program during next year’s session.
“The facts are it is what every other (Medicaid) program has been: a fiscal failure,” Republican Sen. Bart Hester said. “Do I think there’s going to be some debate over the future of this program? Absolutely.”
Republican Gov. Asa Hutchinson earlier this year managed to save the program through a procedural maneuver that relied on supporters of the expansion to vote for its end, with his vow to strike that language through a line-item veto. That move was needed after it was clear there wasn’t the three-fourths vote necessary to reauthorize the program, despite it having support from clear majorities in both chambers of the Legislature.
It’s unclear just how tough getting the three-fourths vote needed for the program’s reauthorization will be, or whether the line-item approach will be needed again. Even if Republicans win what could be an uphill fight for the White House and to retain control of the U.S. Senate, that won’t mean their vow to end the federal health care law that led to Medicaid expansion will come to fruition next year.
Republican Sen. Jim Hendren, who co-chairs the Health Reform Legislative Task Force, said the rate increases Arkansas and other states are seeing for the exchange show the challenges the next president will face in tackling the federal health law next year.
“Regardless of who wins, they are rapidly going to find an unraveling program on their desk,”Hendren said. “It’s either going to completely unravel or they’re going to have to make some dramatic changes.”
Hendren and other Republicans who have supported the hybrid expansion said they’re hoping whoever is president next is willing to give the state more flexibility for restrictions on the expanded coverage. The limits include co-pays for emergency room visits, something Hendren said the Obama administration hasn’t been willing to allow.
Hutchinson said the growth in the program emphasizes the need for the changes the state is seeking to the expanded coverage, including its proposal to move some on the program to subsidized, employer-based plans.
“My hope is that with the reform measures put in, that there will be some natural constraint in the numbers that shift over to the expanded Medicaid program,” he said. “But it is a cost issue, and we really have to push Washington to give us more flexibility so we can cover the numbers better and the cost better.”
Andrew DeMillo has covered Arkansas government and politics for The Associated Press since 2005. Follow him on Twitter at Twitter.com/ademillo.
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