Posted 11/3/2013 08:37 am
Updated 4 months ago
LITTLE ROCK — The computer problems that have frustrated many Americans trying to sign up for insurance under the federal health care law aren't just a political liability for those in Washington who supported the 2010 law. They could also threaten Arkansas' compromise plan to expand insurance coverage to thousands of low income workers.
The glitches with the online insurance marketplace — as well as a wave of cancellation notices hitting individuals and small businesses that buy their own insurance— are giving opponents of Arkansas' private option plan to expand Medicaid new ammunition to argue for its defunding when the Legislature convenes next year. The private option's chief supporters acknowledge the rollout woes at the national level could make for an uphill battle in winning the funding fight next year.
"You'd be a fool to not be concerned," said Rep. John Burris, R-Harrison, who was one of the chief sponsors of the plan, which calls for using federal Medicaid money to purchase private insurance for thousands of low-income workers. "The argument for the private option was never that the federal government was a competent and trusted partner. It was actually the opposite. That's certainly proven to be true."
Obama administration officials have vowed to fix the computer problems that have plagued the insurance exchange site by the end of the month, but the glitches are likely to linger as a political issue heading into next year's election. Targeted by Democrats hoping for a boost from the government shutdown, U.S. Rep. Tom Cotton has tried to shift attention back to the health care law and the rollout woes as he tries to unseat U.S. Sen. Mark Pryor next year.
The rollout problems jeopardize what was already a shaky partnership between Democrats and some Republicans in the Legislature like Burris, who argued that the private option gave lawmakers a chance to enact conservative reforms to the state's Medicaid program.
Just how much that coalition will be threatened will become clear in February, when lawmakers return for the legislative session focused primarily on the state's budget. Much of the session's debate will likely focus on the private option, and the funding bill that will allow it to continue. The appropriation bill will need at least 75 votes in the House and 27 in the Senate.
With the filing period for state and federal offices likely to overlap with the session, the debate is almost certain to be heightened by the 2014 campaign and the pressures Republican supporters of the private option may feel as they face heated primaries.
One of the first casualties of that pressure could the support of state Rep. Ann Clemmer, who announced last week she was running for Arkansas' 2ndcongressional district. Clemmer had voted against the private option legislation but for its accompanying funding bill.
In announcing her bid, Clemmer suggested that legislators were considering delaying the private option's implementation — a claim denied by architects of the law who note that coverage begins in January, before the fiscal session begins. Clemmer also left open the possibility that she may vote against the funding bill when it comes up again in February.
"If it's not going to work, then I'm going to vote no," Clemmer said. "If we see that insurance rates are better for Arkansans and we've got this thing that we've rolled out and it's working well and it's lowering insurance rates, then we might leave it alone. But if it's driving insurance costs up, not down, then we want to stop it before it gets further along."
Supporters aren't just at risk of losing Republicans. At a hearing last week, at least two Democrats who had voted for the private option expressed concerns about the reduction in reimbursements some specialty doctors will receive under the expansion plan.
Any effort to block funding for the private option would face complications, including what it would mean for the thousands who would be covered starting Jan. 1. It also could set up a renewed fight over the tax cut package lawmakers approved earlier this year, which was passed with the expectation that savings from the private option would help make up for the loss in revenue.
"If you don't continue it, you've either got to repeal your tax cuts or else what?...You're either going to have to do away with the tax cuts, and what's the likelihood of that? " Gov. Mike Beebe said last week. "Or you're going to have to take it away from somebody else. Or you're going to underfund Medicaid."
The questions also come on the heels of a key legislative victory for opponents of the health care law, who blocked additional funding for marketing and promoting the state's insurance exchange. It also could overshadow the success state officials say they're seeing with the private option. Unlike the health exchange — which has seen less than 200 people sign up because of the computer glitches, the state has already enrolled thousands in the private option program.
Architects of the private option say they're concerned about the impact the rollout's problems will have on the private option, but say they're still focusing on how to implement the law and the accompanying reforms to the state's Medicaid program.
"The missteps that are happening at the federal level absolutely impact what happens here in the state," said state Sen. Jonathan Dismang, R-Beebe. "At this point, we still are examining the private option and making sure it's what we thought it would be. To date, it seems that it is."
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