Who Will Say No to Private Option? (Feedback)

During the last session, key Republican legislators put aside their dislike of Obamacare to craft a unique way to accept federal dollars to provide health insurance to Arkansans who desperately need it: the “private option.” Thank you, Sens. Sanders, Dismang and Burris. Thank you, Rep. Murdock and others who worked behind the scenes to make Arkansas a health care innovations model for the nation.

At a time when our two-party federal government has reached a new level of childish bad behavior, Arkansas is an example of bipartisan governing at its very best. Reports of our accomplishments have been touted by the media in every state. At the same time, news outlets in states whose taxpayer dollars will help pay for unprecedented health care access in Arkansas and 26 other states (plus the District of Columbia) are printing sad personal stories and warning of the dire consequences of denying similar health care access to their own citizens.

One by one, Republican governors and state legislators are seeing the value of what has been done in Arkansas. Last week, Utah’s Republican Gov. Gary Herbert, long a holdout against Medicaid expansion, jumped on the bandwagon, saying, “Doing nothing is not an option.” The Utah plan emulates the Arkansas private option, as do the Medicaid expansion plans of Iowa and Pennsylvania.

It must have been difficult to vote for the private option during the 2013 general session. It was an untested health care plan that could not be implemented without approval from the Centers for Medicare & Medicaid Services. I applaud the 105 Democratic and Republican legislators who took that leap of faith. Only Sens. Bledsoe, Clark, English, Hendren, Hester, King and Stubblefield did not. In the House, 23 of 100 representatives did not.

But now, with the fiscal session right around the corner, legislators know exactly what they will be voting for or against. Published reports indicate that roughly 100,000 Arkansans have enrolled in health care coverage through Arkansas’ federally facilitated marketplace. The private option is working “exactly like the Legislature asked us to build it and enrollment is above where it should be,” to quote DHS Director John Selig speaking before the Joint Budget Committee on Jan. 21. Estimates of the cost per enrollee are right on target, and the percentage of 18- to 35-year-old signups has created a desirable risk pool to attract insurance carriers to Arkansas and keep premiums competitive. Michael Leavitt, a former Utah governor and U.S. Health & Human Services secretary now consulting for Arkansas on amendments to the private option waiver, told legislators that Arkansas could be a national leader in making Medicaid more efficient. He said the private option “is not just pioneering; it is truly transforming.”

If Arkansas legislators renew their support for the private option, our state will retain its place in history as a leader in health care system transformation. For the first time, our hospitals and physicians will be able to make a noticeable dent in the profound health disparities causing a 10-year difference in life expectancy between Benton and Phillips counties. Providing health care to uninsured people across the state will systematically attack our “bottom-of-the-barrel” health statistics — one chronic disease at a time.

But what if our legislators vote to end the private option and snatch health care services away from people who may be visiting a primary care physician for the first time in their lives as we speak? What if access to preventive care is taken away from Arkansans who had begun to hope that their lives might not be colored by progressive disability and the prospect of early death?

If the private option is defeated, the names of the legislators who voted against allowing folks to keep the health care services they have only just begun to appreciate will be recorded forever in Arkansas history. The families who will lose a wage-earning father to a heart attack at an early age will know who to blame. Diabetics who lose a limb to amputation will remember the legislators who denied them health care when the vision of a healthier state was on the table, just one vote away. Think about it, legislators, how do you want to be remembered?

Gloria Gordon
North Little Rock