Posted 10/6/2013 09:34 am
Updated 10 months ago
LITTLE ROCK — Arkansas receives final approval to expand coverage to 250,000 low-income workers using a key part of the federal health care law. Days later, some of the same Republicans who crafted that plan reject efforts to promote the exchanges set up under the federal health care law.
The state's Republican congressmen and senator back efforts to tie defunding the federal health care law to spending bills, prompting a federal government shutdown. Thousands of Arkansans, meanwhile, flock to the online insurance marketplace eager to sign up for coverage but face delays because of widespread national demand.
If anyone was unsure just how difficult of a balance Arkansas faces in trying to implement the federal health care overhaul, the rollout over the past week made it clear. After two elections and two legislative sessions that have been overshadowed by the 2010 law, the state is facing an identity crisis on how to move forward with it.
Nowhere is that clearer than the state Legislature, where wounds still run deep among Republicans over the "private option" plan to use Medicaid funds to purchase private insurance for thousands of residents. The federal government last month approved the plan, and state officials say more than 55,000 people have already said they want to sign up.
But with Republicans opposed to the private option vowing to push for its defunding during next year's legislative session, lawmakers are likely to face a renewed fight over the health care at the same time many of them are gearing up for re-election and possibly facing heated primaries.
The rejection of the advertising contract offers a hint of just how messy the private option fight could get next year.
The $4.5 million contract called for spending federal funds on television, radio, direct mail and other advertising for the insurance exchange. Initially delayed until the state released information on the rates charged by the marketplace, the vote by the Arkansas Legislative Council last week turned into a proxy fight over the health care law.
"The big picture is, we're just an election cycle away from this possibly changing," said Sen. Bryan King, R-Green Forest, who noted that the contract was being considered at the same time the federal government was about to shut down over efforts to defund the health care law.
The party line vote showed that even after a session where some Republicans supported a compromise approach on implementing the federal health care law, the overhaul remains a tricky issue for many within the GOP.
"I think it's rather partisan, frankly," Insurance Commissioner Jay Bradford told reporters afterward. "It's unfortunate, because this is just an educational process to tell people how they can secure coverage on the federal exchange."
Gov. Mike Beebe and Bradford have said they're open to talking with lawmakers about alternatives for promoting the insurance exchange and note that the contract would have helped the state connect residents eligible for the private option that was just approved.
Opponents of the contract included Republican Rep. John Burris, who was one of the lawmakers who helped develop the private option. Though he said voted against the contract because he found it excessive, he also defended the need to educate Arkansans about the exchange and the private option. Burris' comments appeared to leave open the door for a compromise for promoting the exchange.
Burris asked: "If we have a chance to make something less chaotic and less harmful to our citizens, is that our responsibility?...Do we benefit our constituents by leveraging this and making them aware of all of the risks and all of the dangers of what we agree is bad? Or do we just step back and not?"