Posted 4/3/2013 02:31 pm
Updated 11 months ago
LITTLE ROCK — A proposal to use federal dollars to purchase private insurance for low-income Arkansas residents won the approval of a state Senate committee Wednesday, as the idea gained favor among Republicans who have opposed Medicaid expansion.
The Senate Public Health, Welfare and Labor Committee advanced the "private option" proposal lawmakers are considering as an alternative to expanding Medicaid under the federal health care law. Democratic Gov. Mike Beebe has urged the Republican-led Legislature to back the proposal, which he says will save the state money by cutting down on hospitals' uncompensated care costs.
Under the proposal, low-income citizens — those who make up to 138 percent of the poverty line, which amounts to $15,415 per year — would receive private insurance purchased using federal Medicaid dollars. The insurance would be purchased through the exchange created under the federal health care law.
"The feds did have a one-size-fits-all approach for Medicaid expansion in the state, but we thought that Arkansas was unique enough that it deserved the consideration and attention of something like the bill we have in front of us today," Sen. Jonathan Dismang, R-Beebe, told the panel.
The vote came a day after Beebe released a letter from the U.S. Department of Health and Human Services that he said gave the "conceptual" approval for Arkansas to move forward with the private insurance proposal.
The proposal includes a provision that would end the program if the federal funding falls below certain percentages. It also requires the state to seek federal approval to move some children and adults on Medicaid to the insurance exchange.
Lawmakers also would have to revisit the proposal in 2017, when the federal funding for the program begins to drop.
The legislation is winning more support from Republicans, who took control of the Legislature last year partly on a vow to fight the federal health care law and who had opposed expanding Medicaid's eligibility. The Republican leaders of the House and Senate endorsed the proposal on Monday.
Supporters of the bill said they believed it showed how lawmakers could find a bipartisan solution to a divisive issue like the health care law.
"I think this is what separates us from what goes on in Washington, D.C.," said Sen. Paul Bookout, D-Jonesboro, a sponsor of the measure. "I think this was government work at its best."
Dismang and Bookout said they planned to hold a "committee of the whole" hearing before the Senate so state officials can answer lawmakers' questions about the legislation before they vote on the legislation.
Despite the bipartisan support, the proposal still faces long odds. The bill that advanced Wednesday only needs a simple majority in each chamber, but lawmakers must also pass a related budget bill to give it final approval. That budget bill requires a three-fourths vote in each chamber.
The top Republican in the House has signed on as a co-sponsor to the private option proposal, but has called for delaying a final vote until the Legislature meets next year. Rep. Bruce Westerman, the House majority leader, said there's also a possibility he may not vote for the bill in its current form.
"I believe in trusting but verifying. If we pass this bill right now and go home, we're going to go home but have no chance to verify," said Westerman, R-Hot Springs.
Beebe again rejected that proposal, saying it would mean the state would miss out on a year of full federal funding for the insurance proposal. He also called on lawmakers to approve the private option bill before any of $100 million in tax cuts legislative leaders are seeking. Beebe has said the savings created from the private insurance proposal could pay for a substantial amount of tax cuts.
"I've been consistent throughout in saying that if you want tax cuts without hurting people, then you're going to have to pay for them and the private option does that," Beebe said.