The state House of Representatives voted 82-16 Thursday to reauthorize funding for the private-option program, ensuring that tens of thousands of Arkansans will continue to have health care coverage in fiscal 2016.
The measure, Senate Bill 101, received seven votes more than the 75 required for passage.
Also, the House voted 80-16 to form a task force to study other health care options for poor Arkansans, with an eye toward ending the existing private-option program on Dec. 31, 2016.
Before the vote on SB101, House Speaker Jeremy Gillam, R-Judsonia, urged lawmakers to support the legislation.
"I'm asking you to trust our governor, to trust me ... those who have been involved in health care, and the process we've gone through," he said. "I understand given the nature of the letdowns we've experienced, it's kind of tough. Faith sometimes is hard to come by ... but I'm asking you to believe in us long enough and give us a chance to prove that we can make a difference in health care in Arkansas."
The task force measure, Senate Bill 96, was sponsored by Sen. Jim Hendren, R-Sulphur Springs. Creation of the task force was requested by Gov. Asa Hutchinson.
After the votes Thursday, Gillam said he "could not be more proud" of House members, some of whom wrestled with the decision because they had campaigned last fall against the private option. Ultimately, they sided with Hutchinson, he said.
"I think [trust in the new governor] plays a tremendous role in it. ... Thus far he's earned that trust, and I think you saw the members of the House respond to that," he said.
Authorized under the 2010 federal Patient Protection and Affordable Care Act and approved by the state Legislature in 2013, the expansion of the state's Medicaid program (known as the private option) extended eligibility to adults with incomes of up to 138 percent of the poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.
More than 223,000 newly eligible adults had been approved for insurance coverage as of Nov. 30. That included more than 188,000 who were enrolled in private, Medicaid-funded plans on Arkansas' federally operated health insurance exchange. It also includes more than 25,000 who were assigned to the traditional Medicaid program because they were considered to have exceptional health needs, and more than 10,000 who had not yet completed enrollment.
If the program is unchanged, the state will have to pick up 5 percent of the private option's cost starting in 2017, gradually increasing to 10 percent in 2020, when Hutchinson said it will cost the state more than $200 million a year.
Until Thursday afternoon, House leaders had been polling lawmakers to see whether there would be enough votes to pass SB101.
The bill contains an $8 billion appropriation for the Department of Human Services' Medical Services Division, including $1.9 billion for the private option.
In the Legislature's 2014 fiscal session, private-option reauthorization failed four times before passing.
This time, lawmakers voted only one time on the legislation. Eleven of the 16 votes against it were cast by freshman legislators.
Taking the House floor to speak for the bill, Rep. Bob Ballinger, R-Hindsville, joked that lightning might strike since he had spoken so vehemently against the bill in the past.
"Those people that I've been dealing with that have been standing together in opposition to this bill, I want to explain my position," he said. "I don't want to come down here and you to see me light up a yes [on the electronic voting board], when you think I'm voting no. I've worked really hard with the governor's office to get some information. ... I told him, if we got x, y and z, I would feel good and I could vote for it. And we got it."
Rep. Kim Hammer, R-Benton, who has voted several times in the past against reauthorizing the private option, said that in the end it's inhumane to kick people off insurance without much notice. He said he voted for the bill because it included a transition period and aims to fix the Medicaid program.
"I was one of the people who stood in the well a few years ago and said 'If it doesn't work, we're going to come back and change it.' Well, guess what? We're back, and we're changing it," he said. "At the end of the day ... our governor has not done anything that I feel does not at least allow us the opportunity to take our trust and put [it] in him and take us down the road a little bit further."
Also, several freshman legislators who campaigned against the private option spoke for the bill Thursday.
Hot Springs Republican Rep. Laurie Rushing, the chairman of the 41-member freshman caucus, said she voted for the legislation because it will eventually phase out the private option.
"We've had repeated bill after bill after bill come through committee and get shot down. ... This is the only bill that made it to the floor that [ends the private option]," Rushing said. "I knew we didn't have the votes. You gotta go for the less of the two evils, and that's about what it is."
Rushing said that after weeks of study, she decided Tuesday night that she would vote for the measure.
"I had to pray, and I had to trust what my God was showing me and that was a promise that I made to the people to end it, and there was nothing else in the pipeline that would do that," Rushing said. "He made it clear to me. ... I came to peace with it."
House Minority Leader Eddie Armstrong, D-North Little Rock, said the vote marked a great day for Democrats because Arkansans enrolled in the private option will continue to have insurance coverage for now.
He noted that many Democrats were voted out of office, in favor of Republicans who campaigned ardently against the private-option program.
"It was tough to overcome that heartburn," Armstrong said. "Whether you call it the private option or not, we're still focusing on providing access to health care and insurance coverage. ... I'm proud to see more Republicans this time than [in the previous General Assembly stand] up for good principles and good values, the same things the Democratic caucus always has -- standing up for working-class, middle-class Arkansans, and especially those that now have access to health care insurance."
Despite Thursday's vote, some lawmakers say they'll work to end the private option before the Legislature adjourns.
On Wednesday, Rep. Josh Miller, R-Heber Springs, filed House Bill 1262 to terminate the private option and repeal the 2013 legislation that created it. He said he still plans to push the bill, even though he doesn't have much hope for its passage.
When asked why so many of his fellow freshmen voted for the bill, Miller shook his head.
"I wish I could tell you," he said. "I think there are several folks here, freshmen especially, who will have to answer tough questions" from voters.
Metro on 02/06/2015